Modern Dental Professionals, Minnesota PC

NPI #1023250503 in Saint Charles, Minnesota

Provider Information

NPI Number: 1023250503
Entity Type: Organization
Organization Name: Modern Dental Professionals, Minnesota PC
Primary Specialty: Dentist
Enumeration Date: Mar 31, 2009
Last Updated: Mar 31, 2009

Practice Location

Address: 931 WHITEWATER AVE
City: Saint Charles
State: Minnesota
ZIP Code: 55972-1130
Phone: (507) 932-4530

Authorized Official

Name: LORI PELKE
Title: PROFESSIONAL SERVICES COORDINATOR
Phone: (715) 926-5050

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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