Organization
MODERN DENTAL PROFESSIONALS, MN PC
Active
Other names
Midwest Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY W. MOOS DDS (CEO)
(715) 926-5050
Entity
Organization
Contact information
Practice address
379 S MAIN ST, ZUMBROTA, MN 55992-1543
(507) 732-5346
(507) 732-5655
Mailing address
379 S MAIN ST, ZUMBROTA, MN 55992-1543
(507) 732-5346
(507) 732-5655
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11386
MN
Other
Enumeration date
07/21/2009
Last updated
07/21/2009
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