Organization · Type 2 NPI
Michael J. Petersen, D.d.s., P.a.
Dental Clinic/Center · Roseville, MN
NPI number
1053935916
Active
Practice location
3101 Old Highway 8 Ste 303
Roseville, MN 55113-1076
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
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About NPI 1053935916
Michael J. Petersen, D.d.s., P.a.'s National Provider Identifier is 1053935916, issued on Jun 5, 2020. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Roseville, MN. The record was last updated on Jun 5, 2020.