Petersen, Douglas George

Petersen, Douglas George is an individual health care provider with primary practice located at 6545 France Ave S #366, Edina MN 55435-2131. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Petersen, Douglas George can be contacted via phone (952) 926-2763.

Contact Information

Primary practice address

6545 France Ave S #366 Edina MN 55435-2131

Phone: (952) 926-2763

Fax:

Website:

Map and Directions

Health care specialties

Specialty	Code	License #	State
Dental Providers / Periodontics	1223P0300X	D10423	Minnesota

Profile Details

NPI number	1134208630
LBN Legal business name	Petersen, Douglas George
Credentials	Doctor of Dental Surgery (DDS)
Entity	Individual
Sole proprietor ¹	No
Enumeration date	Nov 3rd, 2006
Last updated	Jul 8th, 2007 - about 17 years ago

¹ A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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