Individual
CHARLENE TAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2841 BRYANT AVE S APT 433, MINNEAPOLIS, MN 55408-4894
(612) 999-5201
Mailing address
2841 BRYANT AVE S APT 433, MINNEAPOLIS, MN 55408-4894
(612) 999-5201
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
R602
MN
Other
Enumeration date
07/17/2014
Last updated
07/17/2014
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