Individual
VIRADA KANCHANAPUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
R866
MN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
S262
MN
Other
Enumeration date
09/11/2023
Last updated
06/17/2026
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