Organization
MOUA DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHIA MOUA DDS (CEO)
(612) 810-0978
Entity
Organization
Contact information
Practice address
1770 BLUEWATER LN, WOODBURY, MN 55129-6236
(612) 810-0978
Mailing address
1770 BLUEWATER LN, WOODBURY, MN 55129-6236
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/30/2019
Last updated
11/30/2019
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