Steven Blaine Petersen DDS

NPI 1184840365 - Dentist - 1223G0001X

NPI Details
NPI 1184840365
Gender Male
Enumeration Date 04/17/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
9202 202ND ST W
SUITE 201
LAKEVILLE MN, 55044-7915, US
Phone (952) 469-2818
Fax (952) 469-2566
Business Location
9202 202ND ST W
SUITE 201
LAKEVILLE MN, 55044-7915, US
Phone (952) 469-2818
Fax (952) 469-2566
Toxanomy
Taxonomy Code 1223G0001X
License State Minnesota
License Number D10525
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According to our database, Dr. Steven Blaine Petersen DDS NPI is 1184840365, taxonomy code is 1223G0001X and license number is D10525, license state is located at Minnesota. Steven Blaine Petersen DDS physically located at 9202 202nd St W, Lakeville MN, 55044-7915. NPI Number Steven Blaine Petersen DDS has the Individual type.

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1184840365 NPI number is provided on an as is basis without warranty of any kind. 1184840365 is maintained by the National Plan & Provider Enumeration System. The contents of Steven Blaine Petersen DDS are for informational purposes only.