IndividualActive
Micah Chan, D.M.D., M.S.
NPI 1083083323 · Periodontics · Richfield, MN
Provider details
- NPI number
- 1083083323
- Entity type
- Individual
- Primary specialty
- PeriodonticsDental Providers
- Credential
- D.M.D., M.S.
- Sex
- Male
- Sole proprietor
- Yes
- License
- S99 (MN)
Mailing address
8301 Stanley Rd
Bloomington, MN 55437-1282
Registry dates
- Enumerated
- 2015-09-16
- Last updated
- 2015-09-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.