Individual
KYRA A. IWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
515 DELAWARE ST SE, SCHOOL OF DENTISTRY- DIVISION OF ORTHODONTICS, MINNEAPOLIS, MN 55455-0357
(651) 278-7892
Mailing address
762 MONTANA AVE W, SAINT PAUL, MN 55117-3443
(651) 278-7892
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6260
WI
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D12519
MN
Other
Enumeration date
06/25/2008
Last updated
05/29/2012
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