Michael J. Petersen, D.D.S., P.a.
Organization Active NPI Dental Clinic/Center · Roseville, MN
NPI 1053935916 · NPPES record last updated Jun 5, 2020
Key facts
- NPI
- 1053935916
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- Legal business name
- MICHAEL J. PETERSEN, D.D.S., P.A.
- Practice address
- 3101 Old Highway 8 Ste 303
Roseville, MN 55113-1076 - Phone
- (651) 636-0840
- NPI assigned
- Jun 5, 2020
- Organization subpart
- No
Authorized official
- Name
- Dr. Michael J. Petersen, DDS
- Title
- Owner, Dentist
- Phone
- (651) 636-0840
Practitioners 1
-
Michael James Petersen, D.D.S.
National Provider Directory
Locations
3101 Old Highway 8
Ste 303
Roseville, MN 55113
Phone (651) 636-0840
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Yes |
Addresses
Primary practice location
3101 Old Highway 8 Ste 303
Roseville, MN 55113-1076
Mailing address
3101 Old Highway 8 Ste 303
Roseville, MN 55113-1076
Phone (651) 636-0840
Other providers in Roseville, MN
- Lindsay Merriman
- Metro Treatment of Minnesota LP
- Benjamin Dutton Meyer
- Thomas Joseph Meyer
- Peggye Mezile
- Michael Joyce DPM PA
- Midwest Health Solutions PA
- Midwest Med Management, Inc
- Midwest Radiology, PA
- Midwest Stone Management
All providers in Roseville, MN · Dental Clinic/Center in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.