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Individual

ANDREW HALVERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MDT

Contact information

Practice address
450 SYNDICATE ST N, #300, SAINT PAUL, MN 55104-4107
(651) 254-7374
Mailing address
2651 INNSBRUCK CT, NEW BRIGHTON, MN 55112-6364

Taxonomy

Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
82
MN

Other

Enumeration date
03/21/2017
Last updated
03/21/2017
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