| Matthew J Peterson, Dds, Pa | |
|
124 1st Ave E Cambridge MN 55008-1209 | |
| (763) 689-1554 | |
| Not Available |
| Full Name | Matthew J Peterson, Dds, Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 124 1st Ave E, Cambridge, Minnesota |
| Authorized Official Name and Position | Matthew J Peterson (PRESIDENT) |
| Authorized Official Contact | 7636891554 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew J Peterson, Dds, Pa 124 1st Ave E Cambridge MN 55008-1209 Ph: (763) 689-1554 | Matthew J Peterson, Dds, Pa 124 1st Ave E Cambridge MN 55008-1209 Ph: (763) 689-1554 |
| NPI Number | 1366539082 |
|---|---|
| Provider Enumeration Date | 10/06/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366539082 | NPI | - | NPPES |
| 307G4CA | Other | MN | BLUE CROSS BLUE SHIELD |
| 7845201 | Other | MN | MN TAX ID # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 11782 (Minnesota) | Primary |
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