Modern Dental Professionals, Mn PC
NPI #1144513565 in Worthington, Minnesota
Provider Information
- NPI Number
- 1144513565
- Entity Type
- Organization
- Organization Name
- Modern Dental Professionals, Mn PC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 18, 2011
- Last Updated
- May 18, 2011
Practice Location
- Address
- 507 S SHORE DR
- City
- Worthington
- State
- Minnesota
- ZIP Code
- 56187-1400
- Phone
- (507) 372-2072
Authorized Official
- Name
- DR. JEFFREY W MOOS, DDS
- Title
- CEO
- Phone
- (715) 926-5050
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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