Individual
MS. KHIN MIMI SAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCHD
Contact information
Practice address
477 VIKING DRIVE, SUITE 190, VA BEACH, VA 23452-7354
(757) 486-8181
(757) 463-0148
Mailing address
477 VIKING DRIVE, SUITE 190, VA BEACH, VA 23452-7354
(757) 486-8181
(757) 463-0148
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
0401416690
VA
Other
Enumeration date
11/15/2016
Last updated
05/21/2021
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