Individual
MRS. KELLY ANNE TIKKANEN LANG
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
261 HWY 10 NE, BLAINE, MN 55434
(763) 786-9644
(763) 786-8602
Mailing address
PO BOX 23029, RICHFIELD, MN 55423
(612) 861-9123
(612) 861-9155
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11650
MN
Other
Enumeration date
04/27/2006
Last updated
07/08/2007
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