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Petersen Dental Clinic PA

NPI #1184835027 in Elko, Minnesota

Provider Information

NPI Number
1184835027
Entity Type
Organization
Organization Name
Petersen Dental Clinic PA
Primary Specialty
Dentist - General Practice
Enumeration Date
May 24, 2007
Last Updated
Jul 15, 2008

Practice Location

Address
730 MAIN ST
Address 2
SUITE 2
City
Elko
State
Minnesota
ZIP Code
55020-9701
Phone
(952) 461-5113

Authorized Official

Name
DR. STEVEN BLAINE PETERSEN, DDS
Title
OWNER
Phone
(952) 461-5113

Specialties & Taxonomy Codes

Specialty
Dentist - General Practice — General Practice

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