Organization
MODERN DENTAL PROFESSIONALS MN PC
Active
Other names
Midwest Dental - Hinckley
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORI J PELKE (PROFESSIONAL SERVICES)
(715) 926-5050
Entity
Organization
Contact information
Practice address
302 FIRE MONUMENT RD, HINCKLEY, MN 55037-8350
(320) 384-6118
(320) 384-6832
Mailing address
680 HEHLI WAY, MONDOVI, WI 54755-1639
(715) 926-5050
(715) 926-4269
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11386
MN
Other
Enumeration date
10/02/2008
Last updated
10/02/2008
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