OrganizationActive
Modern Dental Professionals, Minnesota PC
NPI 1104147735 · Dentist · Centerville, MN
Provider details
- NPI number
- 1104147735
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Jeffrey Moos, President(715) 926-5050
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(83/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1853 Main St
Centerville, MN 55038-9794
Phone: (651) 653-3272
Fax: (651) 653-3272
Street-level locationGet directions
Mailing address
1853 Main St
Centerville, MN 55038-9794
Other names (DBA / former)
- Doing business as
- Midwest Dental
Registry dates
- Enumerated
- 2010-06-17
- Last updated
- 2010-06-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.