DR. Mark Stan Halversen, DDS

NPI #1336271402 in Delaware, Ohio

Provider Information

NPI Number: 1336271402
Entity Type: Individual
Name: DR. Mark Stan Halversen, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Mar 12, 2007
Last Updated: Apr 13, 2009

Practice Location

Address: 1179 COLUMBUS PIKE
Address 2: STATE ROUTE 23
City: Delaware
State: Ohio
ZIP Code: 43015-2713
Phone: (740) 362-2202

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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