NPI | 1821356502 |
---|---|
Doing Business As | MIDWEST DENTAL - ST. LOUIS PARK |
Entity Type | Organization |
Authorized Contact | JEFFREY W MOOS Owner 715-926-5050 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2012-05-01 |
Last Update Date | 2012-05-01 |