Organization
MODERN DENTAL PROFESSIONALS, MN PC
Active
Other names
Midwest Dental - St. Cloud
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES MYER (CFO)
(715) 926-5050
Entity
Organization
Contact information
Practice address
4140 THIELMAN LN, SUITE 302, SAINT CLOUD, MN 56301-7326
(320) 252-7752
(320) 252-2289
Mailing address
4140 THIELMAN LN, SUITE 302, SAINT CLOUD, MN 56301-7326
(320) 252-7752
(320) 252-2289
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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