| Modern Dental Professionals Mn Pc | |
|
195 Jefferson Blvd Big Lake MN 55309-9572 | |
| (763) 280-5711 | |
| (763) 263-5822 |
| Full Name | Modern Dental Professionals Mn Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 195 Jefferson Blvd, Big Lake, Minnesota |
| Authorized Official Name and Position | Jeffrey Moos (OWNER) |
| Authorized Official Contact | 7158292791 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Dental Professionals Mn Pc 195 Jefferson Blvd Big Lake MN 55309-9572 Ph: (763) 280-5711 | Modern Dental Professionals Mn Pc 195 Jefferson Blvd Big Lake MN 55309-9572 Ph: (763) 280-5711 |
| NPI Number | 1215307061 |
|---|---|
| Provider Enumeration Date | 10/05/2015 |
| Last Update Date | 10/05/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215307061 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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