Provider Demographics
NPI:1982097325
Name:HOVERSON, NORAH (DDS)
Entity Type:Individual
Prefix:DR
First Name:NORAH
Middle Name:
Last Name:HOVERSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 NICOLLET MALL STE 1737
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402-2704
Mailing Address - Country:US
Mailing Address - Phone:612-332-1164
Mailing Address - Fax:
Practice Address - Street 1:825 NICOLLET MALL STE 1737
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-2704
Practice Address - Country:US
Practice Address - Phone:612-332-1164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-10
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND14113122300000X
WADE60654550122300000X
WADR60555248122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist