| Modern Dental Professionals, Mn Pc | |
|
560 Debra Dr Lewiston MN 55952-2104 | |
| (507) 523-2267 | |
| Not Available |
| Full Name | Modern Dental Professionals, Mn Pc |
|---|---|
| Speciality | Dentist |
| Location | 560 Debra Dr, Lewiston, Minnesota |
| Authorized Official Name and Position | Jeffrey W Moos (CEO) |
| Authorized Official Contact | 7159265050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Dental Professionals, Mn Pc 560 Debra Dr Lewiston MN 55952-2104 Ph: (507) 523-2267 | Modern Dental Professionals, Mn Pc 560 Debra Dr Lewiston MN 55952-2104 Ph: (507) 523-2267 |
| NPI Number | 1073796744 |
|---|---|
| Provider Enumeration Date | 12/17/2007 |
| Last Update Date | 12/17/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073796744 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D11386 (Minnesota) | Primary |
Lewiston Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 560 Debra Dr, Lewiston, MN 55952 Phone: 507-523-1071 Fax: 507-523-1078 |