Michael James Petersen D.D.S.

NPI 1407902307 - Dentist - 1223G0001X

NPI Details
NPI 1407902307
Gender Male
Enumeration Date 01/25/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
3101 OLD HIGHWAY 8
SUITE #303
ROSEVILLE MN, 55113-1072, US
Phone (651) 636-0840
Fax (651) 633-1760
Business Location
3101 OLD HIGHWAY 8
SUITE #303
ROSEVILLE MN, 55113-1072, US
Phone (651) 636-0840
Fax (651) 633-1760
Toxanomy
Taxonomy Code 1223G0001X
License State Minnesota
License Number 9923
Remove 1407902307 NPI Number
 

According to our database, Dr. Michael James Petersen D.D.S. NPI is 1407902307, taxonomy code is 1223G0001X and license number is 9923, license state is located at Minnesota. Michael James Petersen D.D.S. physically located at 3101 Old Highway 8, Roseville MN, 55113-1072. NPI Number Michael James Petersen D.D.S. has the Individual type.

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1407902307 NPI number is provided on an as is basis without warranty of any kind. 1407902307 is maintained by the National Plan & Provider Enumeration System. The contents of Michael James Petersen D.D.S. are for informational purposes only.