Individual
DR. JASON CHAN YICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9630 GROVE CIR N STE 102, MAPLE GROVE, MN 55369-3480
(763) 420-5484
Mailing address
9630 GROVE CIR N STE 102, MAPLE GROVE, MN 55369-3480
(612) 356-0289
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D14183
MN
Other
Enumeration date
05/15/2019
Last updated
06/26/2019
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