Whalio Doctors

NPI 1134637143

Lucky Vang

Practitioner Advanced Practice Dental Therapist Saint Paul, MN

Practice location

Address
409 Dunlap St N, Saint Paul, MN 55104-4201
Phone
(651) 290-9200
Mailing address
2228 E Lake St, Minneapolis, MN 55407-4321

Registered specialties (2)

Advanced Practice Dental Therapist Primary
Dental Providers Taxonomy 125K00000X Licence DT71 (MN)
Dental Therapist
Dental Providers Taxonomy 125J00000X Licence DT71 (MN)

Registry record

NPI
1134637143
Entity type
Individual
Sex (as registered)
Male
NPI issued
12 Jan 2018
Record last updated
2 May 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.