| 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 |