Organization
MARK J MODJEAN DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK JOHN MODJEAN DDS (PRES)
(612) 866-3322
Entity
Organization
Contact information
Practice address
7001 NICOLLET AVE S, RICHFIELD, MN 55423-3162
(612) 866-3322
Mailing address
7001 NICOLLET AVE S, RICHFIELD, MN 55423-3162
(612) 866-3322
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8439
MN
Other
Enumeration date
11/11/2005
Last updated
08/22/2020
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