Modern Dental Professionals Minnesota PC

NPI #1255639696 in Eagan, Minnesota

Provider Information

NPI Number: 1255639696
Entity Type: Organization
Organization Name: Modern Dental Professionals Minnesota PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 9, 2011
Last Updated: Mar 9, 2011

Practice Location

Address: 1121 TOWN CENTRE DR
Address 2: #200
City: Eagan
State: Minnesota
ZIP Code: 55123-1199
Phone: (651) 454-4771

Authorized Official

Name: JAMES MYER
Title: CFO
Phone: (715) 926-5050

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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