DR. Michael James Petersen, D.D.S.

NPI #1407902307 in Roseville, Minnesota

Provider Information

NPI Number: 1407902307
Entity Type: Individual
Name: DR. Michael James Petersen, D.D.S.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: D.D.S.
Enumeration Date: Jan 25, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 3101 OLD HIGHWAY 8
Address 2: SUITE #303
City: Roseville
State: Minnesota
ZIP Code: 55113-1072
Phone: (651) 636-0840

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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