| Modern Dental Professionals, Minnesota Pc | |
|
412 Heritage Pl Faribault MN 55021-5248 | |
| (507) 334-7595 | |
| Not Available |
| Full Name | Modern Dental Professionals, Minnesota Pc |
|---|---|
| Speciality | Dentist |
| Location | 412 Heritage Pl, Faribault, Minnesota |
| Authorized Official Name and Position | Lori Pelke (PROFESSIONAL SERVICES) |
| 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 680 Hehli Way Mondovi WI 54755-1639 Ph: (715) 926-5050 | Modern Dental Professionals, Minnesota Pc 412 Heritage Pl Faribault MN 55021-5248 Ph: (507) 334-7595 |
| NPI Number | 1427298637 |
|---|---|
| Provider Enumeration Date | 02/27/2009 |
| Last Update Date | 02/27/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427298637 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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