| Modern Dental Professionals | |
|
676 County Road 10 Ne Blaine MN 55434-2329 | |
| (763) 780-5007 | |
| Not Available |
| Full Name | Modern Dental Professionals |
|---|---|
| Speciality | Dentist |
| Location | 676 County Road 10 Ne, Blaine, Minnesota |
| Authorized Official Name and Position | Brent Althoff (CREDENTIALING MANAGER) |
| Authorized Official Contact | 7152034689 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Dental Professionals 676 County Road 10 Ne Blaine MN 55434-2329 Ph: (763) 780-5007 | Modern Dental Professionals 676 County Road 10 Ne Blaine MN 55434-2329 Ph: (763) 780-5007 |
| NPI Number | 1730788498 |
|---|---|
| Provider Enumeration Date | 10/22/2020 |
| Last Update Date | 10/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730788498 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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