Individual
PAO CHUA VANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1670 BEAM AVE STE 204, MAPLEWOOD, MN 55109-1227
(651) 925-8400
Mailing address
900 COUNTY ROAD D W APT 307, NEW BRIGHTON, MN 55112-7563
(612) 810-1103
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D14098
MN
Other
Enumeration date
07/29/2018
Last updated
07/29/2018
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