Peterson, Scott Mathew
Peterson, Scott Mathew is an individual health care provider with primary practice located at 111 N Regency Dr , Bloomington IL 61701-3515. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Peterson, Scott Mathew can be contacted via phone (309) 662-5331.Contact Information
Primary practice address
111 N Regency Dr
Bloomington IL 61701-3515
Phone: (309) 662-5331
Fax: (309) 663-1112
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 021-002109 | Illinois |
Profile Details
| NPI number | 1134396336 |
|---|---|
| LBN Legal business name | Peterson, Scott Mathew |
| Credentials | DDS, MS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 15th, 2008 |
| Last updated | May 15th, 2008 - 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.
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