Modern Dental Professionals Minnesota PC
Organization Active NPI General Practice Dentistry · West Saint Paul, MN
NPI 1487940284 · NPPES record last updated Jun 21, 2011
Key facts
- NPI
- 1487940284
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Legal business name
- MODERN DENTAL PROFESSIONALS MINNESOTA PC
- Practice address
- 2059 Robert St S
West Saint Paul, MN 55118-3924 - Phone
- (651) 457-9633
- Fax
- (651) 457-3849
- NPI assigned
- Jun 21, 2011
- Organization subpart
- No
Authorized official
- Name
- Jeffrey W. Moos, DDS
- Title
- Ceo
- Phone
- (715) 926-5050
Corporate family (same tax ID) 38
Practitioners 2
-
Timothy Alworth Anderson, D.D.S
-
David V Sass, DDS
National Provider Directory
- Tax ID family
- Midwest Dental
Locations
2059 Robert St S
West St Paul, MN 55118
Phone (651) 457-9633
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | Yes |
Addresses
Primary practice location
2059 Robert St S
West Saint Paul, MN 55118-3924
Mailing address
2059 Robert St S
West Saint Paul, MN 55118-3924
Phone (651) 457-9633
Other names
- Midwest Dental
Other providers in West Saint Paul, MN
- Mercy Hill Health LLC
- Nathan Andrew Milender
- Justyn Patrick Mileski
- Meleah H. Miller
- Robert Parnell Miller
- Scott Andrew Mooring
- Mindy Nguyen
- Nur I Odowa
- Justine Olson
- Patient Centered Care LLC
All providers in West Saint Paul, MN · General Practice Dentistry in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.