Mark Daniel Severt DDS

NPI 1417016486 - Dentist - 1223G0001X

NPI Details
NPI 1417016486
Gender Male
Enumeration Date 12/06/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
9055 SPRINGBROOK DR NW
#201
COON RAPIDS MN, 55433-5841, US
Phone (763) 786-4632
Fax (763) 786-8673
Business Location
2326 HENDON AVE
SAINT PAUL MN, 55108-1453, US
Phone (651) 646-1990
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Minnesota
License Number D11049
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According to our database, Dr. Mark Daniel Severt DDS NPI is 1417016486, taxonomy code is 1223G0001X and license number is D11049, license state is located at Minnesota. Mark Daniel Severt DDS physically located at 9055 Springbrook Dr Nw, Coon Rapids MN, 55433-5841. NPI Number Mark Daniel Severt DDS has the Individual type.

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1417016486 NPI number is provided on an as is basis without warranty of any kind. 1417016486 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Daniel Severt DDS are for informational purposes only.