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Organization

SEVERS ORTHODONTICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GRANT STEVEN SEVERS DMD MS (PRESIDENT)
(217) 919-5008
Entity
Organization

Contact information

Practice address
3915 MAINE ST STE 2, QUINCY, IL 62305-5843
(309) 255-5169
Mailing address
3915 MAINE ST STE 2, QUINCY, IL 62305-5843
(309) 255-5169

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary

Other

Enumeration date
11/08/2023
Last updated
11/08/2023
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