Individual
VIRADA KANCHANAPUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
515 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0357
(612) 625-5000
Mailing address
2949 4TH ST SE UNIT 306, MINNEAPOLIS, MN 55414-3897
(612) 309-7495
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
R866
MN
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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