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Individual

LANCE SVOBODA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS, MS

Contact information

Practice address
701 PARK AVE, P7, MINNEAPOLIS, MN 55415-1623
(612) 873-2370
Mailing address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D11474
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
093455100
MN
Enumeration date
06/05/2006
Last updated
07/30/2007
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