NPI 1093442048

Wang Periodontics PLLC

Organisation Periodontics Maple Grove, MN

Practice location

Address: 12000 Elm Creek Blvd N STE 320, Maple Grove, MN 55369-7076
Phone: (763) 420-0200
Mailing address: 18145 59th Ave N, Plymouth, MN 55446-3936

Authorised official

Name: Yun Wang
Title: President
Phone: (517) 648-3576

Registered specialties

Periodontics Primary

Dental Providers Taxonomy 1223P0300X

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Registry record

NPI: 1093442048
Entity type: Organization
NPI issued: 1 Aug 2022
Record last updated: 7 Sep 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.