Organization
MODERN DENTAL PROFESSIONALS MINNESOTA PC
Active
Other names
Midwest Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY MOOS DDS (PC OWNER)
(715) 926-5050
Entity
Organization
Contact information
Practice address
1400 BAKER PARK RD, SUITE 1040, MAPLE PLAIN, MN 55359-9851
(763) 402-7003
(763) 447-3208
Mailing address
1400 BAKER PARK RD, SUITE 1040, MAPLE PLAIN, MN 55359-9851
(763) 402-7003
(763) 447-3208
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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