Individual
DR. GRANT STEVEN KORSMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2401 S WASHINGTON ST, STE C, GRAND FORKS, ND 58201-6747
(701) 775-0682
(701) 772-9697
Mailing address
2401 S WASHINGTON ST, STE C, GRAND FORKS, ND 58201-6747
(701) 775-0682
(701) 772-9697
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2008
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28751
BCBS OF ND
ND
05
—
41429
—
ND
05
—
640087000
—
MN
01
—
9200472
DENTAQUEST
—
01
—
949382
DENTAL SERVICE CORPORATION OF NORTH DAKOTA
ND
Enumeration date
06/05/2007
Last updated
09/24/2019
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