Individual
DR. MATTHEW JAMES MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
14741 VICTOR HUGO BLVD N, HUGO, MN 55038-4561
(651) 407-0999
Mailing address
18753 MELROSE CHASE, EDEN PRAIRIE, MN 55347-3483
(612) 590-6448
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D15093
MN
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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