Organization
MODERN DENTAL PROFESSIONALS MINNESOTA PC
Active
Other names
Midwest Dental - White Bear Lake
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD HENDRICKS (DIRECTOR, PAYER STRATEGY)
(612) 351-6876
Entity
Organization
Contact information
Practice address
4520 CENTERVILLE RD, SAINT PAUL, MN 55127-3602
(651) 426-4799
(651) 426-8106
Mailing address
680 HEHLI WAY, MONDOVI, WI 54755-1639
(715) 598-2311
(715) 350-6855
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
MN
Other
Enumeration date
03/16/2018
Last updated
03/16/2018
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