| Mark T. Sherman Dds Pa | |
|
31011 Rasmussen Rd Pequot Lakes MN 56472-1227 | |
| (218) 568-8295 | |
| Not Available |
| Full Name | Mark T. Sherman Dds Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 31011 Rasmussen Rd, Pequot Lakes, Minnesota |
| Authorized Official Name and Position | Mark T Sherman (OWNER) |
| Authorized Official Contact | 2185688295 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark T. Sherman Dds Pa Po Box 128 Pequot Lakes MN 56472-0128 Ph: (218) 568-8295 | Mark T. Sherman Dds Pa 31011 Rasmussen Rd Pequot Lakes MN 56472-1227 Ph: (218) 568-8295 |
| NPI Number | 1770195158 |
|---|---|
| Provider Enumeration Date | 08/18/2020 |
| Last Update Date | 08/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770195158 | NPI | - | NPPES |
| D11015 | Other | MN | BOARD LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Lakes Dental Care Plc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 31052 Goverment Dr, Pequot Lakes, MN 56472 Phone: 218-568-5011 Fax: 218-568-6851 |