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Pathamas Chantaracherd Mittman, DDS,MS
Orofacial Pain Dentist in Plymouth, Minnesota
NPI 1447972922

Pathamas Chantaracherd Mittman is a Orofacial Pain Dentist based in Plymouth, MN and is specialized in Orofacial Pain. Pathamas Chantaracherd Mittman practices in Plymouth, MN and has the professional credentials of DDS,MS. The NPI Number for Pathamas Chantaracherd Mittman is 1447972922 and holds a License No. S187 (Minnesota).

The current practice location address for Pathamas Chantaracherd Mittman is 3475 Plymouth Blvd Ste 200, Plymouth, MN and can be reached out via phone at 763-577-2484 and via fax at 763-577-1375.

Location: 3475 Plymouth Blvd Ste 200, Plymouth, MN, 55447-1539
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1447972922
Provider Name
Pathamas Chantaracherd Mittman
Credential
DDS,MS
Provider Entity Type
Individual
Gender
Female
Address
3475 Plymouth Blvd Ste 200, Plymouth, MN, 55447-1539
Phone Number
763-577-2484
Fax Number
763-577-1375
Provider Enumeration Date
09/13/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3475 Plymouth Blvd Ste 200
City
Plymouth
State
Minnesota
Zip
55447-1539
Phone Number
763-577-2484
Fax Number
763-577-1375
person
Provider Business Mailing Address Details
Address
3475 Plymouth Blvd Ste 200
City
Plymouth
State
Minnesota
Zip
55447-1539
Phone Number
763-577-2484
Fax Number
763-577-1375
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Orofacial Pain
Taxonomy
1223X2210X
License No.
S187 (Minnesota)
Definition
A dentist who assesses, diagnoses, and treats patients with complex chronic orofacial pain and dysfunction disorders, oromotor and jaw behavior disorders, and chronic head/neck pain. The dentist has successfully completed an accredited postdoctoral orofacial pain residency training program for dentists of two or more years duration, in accord with the Commission on Dental Accreditation's Standards for Orofacial Pain Residency Programs, and/or meets the requirements for examination and board certification by the American Board of Orofacial Pain.
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