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MARK THOMAS SHERMAN D.D.S.
General Practice >> Dentist >> Dental ProvidersRegistrant NPI Number: 1649360470
Individual Registrant: MARK THOMAS SHERMAN D.D.S.
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
30957 OLD HWY 371 PEQUOT LAKES, MN 56472-0128 US
Tel: 218-568-8295 Fax: 218-568-4702
Tel: 218-568-8295 Fax: 218-568-4702
Contact information for business:
PO BOX 128 30957 OLD HWY 371 PEQUOT LAKES, MN 56472-0128 US
Tel: 218-568-8295 Fax: 218-568-4702
Tel: 218-568-8295 Fax: 218-568-4702
Registration Information:
NPI: 1649360470
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1223G0001X | Dental Providers Dentist General Practice | MN | 11015 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
