Peterson, Jake Allen
Peterson, Jake Allen is an sole proprietor health care provider with primary practice located at 1475 Sw Chandler Ave Ste 101 , Bend OR 97702-3239. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Peterson, Jake Allen can be contacted via phone (541) 617-3993.Contact Information
Primary practice address
1475 Sw Chandler Ave Ste 101
Bend OR 97702-3239
Phone: (541) 617-3993
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | M-15171 | Idaho |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | DE60941667 | Washington |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | D-5107-OS | Idaho |
Profile Details
| NPI number | 1043657364 |
|---|---|
| LBN Legal business name | Peterson, Jake Allen |
| Credentials | DDS, MD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 28th, 2013 |
| Last updated | Mar 1st, 2022 - about 2 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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