Individual provider · Type 1 NPI
Troy R. Petersen, DMD MD
Oral and Maxillofacial Surgery (Dentist) · Grand Forks, ND
NPI number
1073697157
Active
Practice location
1165C South Columbia Road
Grand Forks, ND 58201-4007
Fax (701) 772-9643
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) Primary | 1223S0112X | 1897 (ND) |
Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Another provider at this address
Other oral and maxillofacial surgery (dentist) providers in Grand Forks
About NPI 1073697157
Troy R. Petersen, DMD MD's National Provider Identifier is 1073697157, issued on Oct 25, 2006. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Grand Forks, ND. The record was last updated on Jul 8, 2007.