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Organization

MODERN DENTAL PROFESSIONALS MINNESOTA PC

Active
Other names
Midwest Dental
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY W. MOOS DDS (CEO)
(715) 926-5050
Entity
Organization

Contact information

Practice address
2059 ROBERT ST S, WEST SAINT PAUL, MN 55118-3924
(651) 457-9633
(651) 457-3849
Mailing address
2059 ROBERT ST S, WEST SAINT PAUL, MN 55118-3924
(651) 457-9633
(651) 457-3849

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
06/21/2011
Last updated
06/21/2011
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