Organization
MODERN DENTAL PROFESSIONALS, MN PC
Active
Other names
Midwest Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY W MOOS DDS (OWNER)
(715) 829-2791
Entity
Organization
Contact information
Practice address
7532 BROOKLYN BLVD, BROOKLYN PARK, MN 55443-3101
(763) 280-5737
(763) 560-1625
Mailing address
7532 BROOKLYN BLVD, BROOKLYN PARK, MN 55443-3101
(763) 280-5737
(763) 560-1625
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/08/2015
Last updated
10/08/2015
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