Individual
COREY VANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5700 BOTTINEAU BLVD STE 270, CRYSTAL, MN 55429-2671
(763) 200-8952
Mailing address
12871 FLAMINGO ST NW, COON RAPIDS, MN 55448-1538
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
$$$$$$$$$
MN
Other
Enumeration date
05/03/2024
Last updated
05/06/2024
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