Organization
MODERN DENTAL PROFESSIONALS MINNESOTA PC
Active
Other names
Midwest Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES MYER (CFO)
(715) 926-5050
Entity
Organization
Contact information
Practice address
925 HIGHWAY 55, SUITE #102, HASTINGS, MN 55033-3734
(651) 437-7844
(651) 437-3454
Mailing address
680 HEHLI WAY, MONDOVI, WI 54755-1639
(715) 926-5050
(715) 926-5405
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
02/19/2010
Last updated
02/19/2010
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