| 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 |