Individual
DR. MARK DANIEL SEVERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9055 SPRINGBROOK DR NW, #201, COON RAPIDS, MN 55433-5841
(763) 786-4632
(763) 786-8673
Mailing address
2326 HENDON AVE, SAINT PAUL, MN 55108-1453
(651) 646-1990
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11049
MN
Other
Enumeration date
12/06/2006
Last updated
07/08/2007
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