Individual
WANGDU DOLMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11850 BLACKFOOT ST NW STE 300, COON RAPIDS, MN 55433-2772
(763) 712-2100
Mailing address
3109 MOUNT RIDGE RD, ROSEVILLE, MN 55113-1225
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8683
MN
Other
Enumeration date
01/04/2022
Last updated
01/20/2022
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