| Modern Dental Professionals, Minnesota Pc | |
|
680 Southview Blvd. South Saint Paul MN 55075 | |
| (651) 455-2297 | |
| (651) 455-9223 |
| Full Name | Modern Dental Professionals, Minnesota Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 680 Southview Blvd., South Saint Paul, Minnesota |
| Authorized Official Name and Position | Lori J 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 Southview Blvd. South St. Paul MN 55075 Ph: (651) 455-2297 | Modern Dental Professionals, Minnesota Pc 680 Southview Blvd. South Saint Paul MN 55075 Ph: (651) 455-2297 |
| NPI Number | 1952546160 |
|---|---|
| Provider Enumeration Date | 12/03/2008 |
| Last Update Date | 12/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952546160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |