Individual
MERISSA VELMA RICHTER MARCUSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
4180 DEAN LAKES BLVD, SHAKOPEE, MN 55379-2851
(952) 233-1020
Mailing address
1121 VAGABOND CT N, PLYMOUTH, MN 55447-2572
(612) 247-2314
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D13693
MN
Other
Enumeration date
04/26/2016
Last updated
09/29/2022
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