Peterson, Gary Ray
Peterson, Gary Ray is an individual health care provider with primary practice located at 3815 Stephens Ave , Missoula MT 59801-8505. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Peterson, Gary Ray can be contacted via phone (406) 728-0200.Contact Information
Primary practice address
3815 Stephens Ave
Missoula MT 59801-8505
Phone: (406) 728-0200
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 1359 | Montana |
Profile Details
| NPI number | 1285799304 |
|---|---|
| LBN Legal business name | Peterson, Gary Ray |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 27th, 2006 |
| Last updated | Apr 13th, 2016 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285799304 | NPPES |
| Montana | MEDICAID | 0120037 |
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