Organization
PAN ORTHODONTIC CLINICS
Active
Organization
PAN ORTHODONTIC CLINICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YU PAN D.D.S., PH.D. (PRESIDENT)
(952) 926-3747
Entity
Organization
Contact information
Practice address
5101 VERNON AVE S, SUITE 502, EDINA, MN 55436-2172
(952) 926-3747
(952) 926-0701
Mailing address
5101 VERNON AVE S, SUITE 502, EDINA, MN 55436-2172
(952) 926-3747
(952) 926-0701
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D12800
MN
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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