Peterson, Benjamin T

Peterson, Benjamin T is an sole proprietor health care provider with primary practice located at 271 Sw 13Th St , Ontario OR 97914-4530. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Peterson, Benjamin T can be contacted via phone (541) 889-9407.

Contact Information

Primary practice address
271 Sw 13Th St Ontario OR 97914-4530
Fax: (541) 889-6551
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D8413 Oregon

Profile Details

NPI number 1720159080
LBN Legal business name Peterson, Benjamin T
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 10th, 2006
Last updated Jun 8th, 2023 - about last year

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 1720159080 NPPES
Oregon MEDICAID 231468

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