| NPI | 1972786655 |
|---|---|
| Doing Business As | MIDWEST DENTAL |
| Entity Type | Organization |
| Authorized Contact | JEFFREY MOOS CEO 715-926-5050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN D11386) |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2007-12-17 |