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Organization

MODERN DENTAL PROFESSIONALS, MINNESOTA PC

Active
Other names
Midwest Dental - St. Louis Park
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY W MOOS DDS (OWNER)
(715) 926-5050
Entity
Organization

Contact information

Practice address
3345 DAKOTA AVE S, ST LOUIS PARK, MN 55416-2039
(952) 929-9450
(952) 929-1095
Mailing address
3345 DAKOTA AVE S, ST LOUIS PARK, MN 55416-2039
(952) 929-9450
(952) 929-1095

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
05/01/2012
Last updated
05/01/2012
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