Modern Dental Professionals, Minnesota PC

NPI #1427298637 in Faribault, Minnesota

Provider Information

NPI Number: 1427298637
Entity Type: Organization
Organization Name: Modern Dental Professionals, Minnesota PC
Primary Specialty: Dentist
Enumeration Date: Feb 27, 2009
Last Updated: Feb 27, 2009

Practice Location

Address: 412 HERITAGE PL
City: Faribault
State: Minnesota
ZIP Code: 55021-5248
Phone: (507) 334-7595

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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