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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
530 WEST PLEASANT, MANKATO, MN 56001
(507) 345-6478
(507) 345-7414
Mailing address
530 WEST PLEASANT, MANKATO, MN 56001
(507) 345-6478
(507) 345-7414

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
08/18/2010
Last updated
08/18/2010
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