Organization
MODERN DENTAL PROFESSIONALS MINNESOTA PC
Active
Other names
Midwest Dental - Seward
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT ALTHOFF (CREDENTIALING MANAGER)
(715) 203-4689
Entity
Organization
Contact information
Practice address
2010 27TH AVE S, MINNEAPOLIS, MN 55406-1108
(612) 336-8478
Mailing address
2010 27TH AVE S, MINNEAPOLIS, MN 55406-1108
(612) 336-8478
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/04/2020
Last updated
08/04/2020
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