Individual
DR. MARK THOMAS LAVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6104 S LYNCREST AVE, SIOUX FALLS, SD 57108-2560
(605) 332-6300
Mailing address
4703 W COTTAGE TRL, SIOUX FALLS, SD 57106-2185
(605) 521-0454
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
6427
NE
1223P0300X
Periodontics
Primary
M981
SD
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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