| 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 |