Provider Demographics
NPI:1346436912
Name:KANGAS, MARCIA A (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:A
Last Name:KANGAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 COUNTY ROAD 42 E
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-6729
Mailing Address - Country:US
Mailing Address - Phone:952-431-5088
Mailing Address - Fax:
Practice Address - Street 1:1100 COUNTY ROAD 42 E
Practice Address - Street 2:SUITE 103
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-6729
Practice Address - Country:US
Practice Address - Phone:952-431-5088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9826122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist