Korsmo, Grant Steven
Korsmo, Grant Steven is an sole proprietor health care provider with primary practice located at 2401 S Washington St Ste C, Grand Forks ND 58201-6747. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Korsmo, Grant Steven can be contacted via phone (701) 775-0682.Contact Information
Primary practice address
2401 S Washington St Ste C
Grand Forks ND 58201-6747
Phone: (701) 775-0682
Fax: (701) 772-9697
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 2008 | North Dakota |
Profile Details
| NPI number | 1467655811 |
|---|---|
| LBN Legal business name | Korsmo, Grant Steven |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 5th, 2007 |
| Last updated | Sep 24th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467655811 | NPPES |
| North Dakota | MEDICAID | 41429 | |
| North Dakota | Other | 9200472 | |
| North Dakota | Other | 28751 | |
| North Dakota | MEDICAID | 640087000 | |
| North Dakota | Other | 949382 |
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