Individual
DR. GRANT SEVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD MS
Contact information
Practice address
3915 MAINE ST STE 2, QUINCY, IL 62305-5843
(217) 919-5008
Mailing address
200 N 30TH ST, QUINCY, IL 62301-3737
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
021.003157
IL
Other
Enumeration date
07/18/2022
Last updated
11/08/2023
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