Modern Dental Professionals, Mn PC
Dentist, General Practice in Mondovi, WI. Organization (NPI-2).
NPI number1124159983
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1124159983
- Entity type
- Organization (NPI-2)
- Legal business name
- Modern Dental Professionals, Mn PC
- Organization subpart
- No
- Enumeration date
- Mar 7, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Other names
- Midwest Dental (Doing Business As)
Practice location
680 Hehli WayMondovi, WI 54755-1639
Phone 715-926-5050
Mailing address
680 Hehli WayMondovi, WI 54755-1639
Phone 715-926-5050
Authorized official
Jim Myer
Cfo
7159265050
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