Modern Dental Professionals Mn PC

NPI #1245413921 in Chatfield, Minnesota

Provider Information

NPI Number: 1245413921
Entity Type: Organization
Organization Name: Modern Dental Professionals Mn PC
Primary Specialty: Dentist
Enumeration Date: Dec 17, 2007
Last Updated: May 18, 2009

Practice Location

Address: 226 MAIN ST S
City: Chatfield
State: Minnesota
ZIP Code: 55923-1225
Phone: (507) 867-3550

Authorized Official

Name: JEFFREY MOOS, DDS
Title: CEO
Phone: (715) 926-5050

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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