| Modern Dental Professionals Minnesota Pc | |
|
1405 78th St Victoria MN 55386-9723 | |
| (952) 443-2994 | |
| (952) 443-2918 |
| Full Name | Modern Dental Professionals Minnesota Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1405 78th St, Victoria, Minnesota |
| Authorized Official Name and Position | James Myer (CFO) |
| 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 1405 78th St Victoria MN 55386-9723 Ph: (952) 443-2994 | Modern Dental Professionals Minnesota Pc 1405 78th St Victoria MN 55386-9723 Ph: (952) 443-2994 |
| NPI Number | 1194053173 |
|---|---|
| Provider Enumeration Date | 12/02/2009 |
| Last Update Date | 12/02/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194053173 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Bruce A. Baker, D.d.s., P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1405 78th St, Victoria, MN 55386 Phone: 952-443-2994 Fax: 952-443-2918 |