| Modern Dental Professionals, Minnesota Pc | |
|
1853 Main St Centerville MN 55038-9794 | |
| (651) 653-3272 | |
| (651) 653-3272 |
| Full Name | Modern Dental Professionals, Minnesota Pc |
|---|---|
| Speciality | Dentist |
| Location | 1853 Main St, Centerville, Minnesota |
| Authorized Official Name and Position | Jeffrey Moos (PRESIDENT) |
| Authorized Official Contact | 7159265050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Dental Professionals, Minnesota Pc 1853 Main St Centerville MN 55038-9794 Ph: (651) 653-3272 | Modern Dental Professionals, Minnesota Pc 1853 Main St Centerville MN 55038-9794 Ph: (651) 653-3272 |
| NPI Number | 1104147735 |
|---|---|
| Provider Enumeration Date | 06/17/2010 |
| Last Update Date | 06/17/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104147735 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |