Individual
DR. TRACY MIAO LIANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
515 DELAWARE ST SE # 320, MINNEAPOLIS, MN 55455-0357
(612) 625-6444
Mailing address
515 DELAWARE ST SE # 320, MINNEAPOLIS, MN 55455-0357
(612) 625-6444
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
R779
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R779
MINNESOTA BOARD OF DENTISTRY
MN
Enumeration date
07/09/2020
Last updated
07/09/2020
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