Petersen, Troy R

Petersen, Troy R is an individual health care provider with primary practice located at 1165C South Columbia Road , Grand Forks ND 58201-4007. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Petersen, Troy R can be contacted via phone (701) 772-7379.

Contact Information

Primary practice address
1165C South Columbia Road Grand Forks ND 58201-4007
Phone: (701) 772-7379
Fax: (701) 772-9643
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 1897 North Dakota

Profile Details

NPI number 1073697157
LBN Legal business name Petersen, Troy R
Credentials DMD MD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1073697157 NPPES
North Dakota MEDICAID 12975
North Dakota Other 252L7PE

Popular Providers