| NPI | 1043589484 |
|---|---|
| Doing Business As | MIDWEST DENTAL - CHISAGO CITY |
| Entity Type | Organization |
| Authorized Contact | JEFFREY MOOS CEO 715-926-5050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2011-12-14 |