Modern Dental Professionals, Mn PC

NPI #1710357520 in Eagan, Minnesota

Provider Information

NPI Number: 1710357520
Entity Type: Organization
Organization Name: Modern Dental Professionals, Mn PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 6, 2015
Last Updated: Oct 6, 2015

Practice Location

Address: 1625 LENA CT
Address 2: SUITE 100
City: Eagan
State: Minnesota
ZIP Code: 55122-2959
Phone: (651) 452-4111

Authorized Official

Name: JEFFREY W. MOOS, DDS
Title: OWNER
Phone: (715) 829-2791

Specialties & Taxonomy Codes

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

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