Petersen, Jeffrey Ian

Petersen, Jeffrey Ian is an individual health care provider with primary practice located at 2448 Guerneville Rd , Santa Rosa CA 95403-4175. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Petersen, Jeffrey Ian can be contacted via phone (707) 579-2808.

Contact Information

Primary practice address

2448 Guerneville Rd Santa Rosa CA 95403-4175

Phone: (707) 579-2808

Fax: (707) 579-2877

Website:

Map and Directions

Health care specialties

Specialty	Code	License #	State
Dental Providers / General Practice	1223G0001X	36313	California

Profile Details

NPI number	1669454211
LBN Legal business name	Petersen, Jeffrey Ian
Credentials	Doctor of Dental Medicine (DMD)
Entity	Individual
Sole proprietor ¹	No
Enumeration date	Nov 18th, 2005
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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