Organization
MODERN DENTAL PROFESSIONALS MINNESOTA PC
Active
Other names
Midwest Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY W MOOS DDS (OWNER)
(715) 926-5050
Entity
Organization
Contact information
Practice address
203 E MAIN ST, SUITE A, MELROSE, MN 56352-4524
(320) 256-4267
(320) 256-4167
Mailing address
203 E MAIN ST, SUITE A, MELROSE, MN 56352-4524
(320) 256-4267
(320) 256-4167
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
MN
Other
Enumeration date
01/06/2014
Last updated
01/06/2014
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