| Peterson Dental Pa | |
|
1579 Hamline Ave N Saint Paul MN 55108-6119 | |
| (651) 646-8851 | |
| (651) 646-4477 |
| Full Name | Peterson Dental Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1579 Hamline Ave N, Saint Paul, Minnesota |
| Authorized Official Name and Position | Donald Peterson (OWNER) |
| Authorized Official Contact | 6516468851 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peterson Dental Pa 1579 Hamline Ave N Saint Paul MN 55108-6119 Ph: (651) 646-8851 | Peterson Dental Pa 1579 Hamline Ave N Saint Paul MN 55108-6119 Ph: (651) 646-8851 |
| NPI Number | 1669046199 |
|---|---|
| Provider Enumeration Date | 05/19/2021 |
| Last Update Date | 05/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669046199 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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