Peterson, Lorin Dean
Peterson, Lorin Dean is an individual health care provider with primary practice located at 77 W Forest Ave Ste 107, Flagstaff AZ 86001-1482. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Pathology, which is considered as his primary health care specialty. Peterson, Lorin Dean can be contacted via phone (928) 773-2530.Contact Information
Primary practice address
77 W Forest Ave Ste 107
Flagstaff AZ 86001-1482
Phone: (928) 773-2530
Fax: (928) 773-2532
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Pathology | 1223P0106X | 2803 | Arizona |
Profile Details
| NPI number | 1699772061 |
|---|---|
| LBN Legal business name | Peterson, Lorin Dean |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2005 |
| Last updated | Jul 17th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699772061 | NPPES |
| Arizona | MEDICAID | 086373 |
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