Petersen, Paris Ernst

Petersen, Paris Ernst is an individual health care provider with primary practice located at 37-53 91St St Marcia D Herrera Dentistry Pc, Jackson Heights NY 11372-7901. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Petersen, Paris Ernst can be contacted via phone (718) 205-4377.

Contact Information

Primary practice address
37-53 91St St Marcia D Herrera Dentistry Pc Jackson Heights NY 11372-7901
Phone: (718) 205-4377
Fax: (718) 205-8605
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 0448791 New York

Profile Details

NPI number 1669454096
LBN Legal business name Petersen, Paris Ernst
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 21st, 2005
Last updated May 20th, 2013 - about 11 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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Identifiers

StateTypeNumberIssuer
All States NPI 1669454096 NPPES
New York MEDICAID 01471874

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