Individual
ERIK J. PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
101 N. HARRISON, LINDSBORG, KS 67456-2417
(785) 227-2299
(785) 227-2620
Mailing address
PO BOX 311, LINDSBORG, KS 67456-0311
(785) 227-2299
(785) 227-2620
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
KS6795
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017300
BLUE CROSS BLUE SHIELD
KS
05
—
1002250008
—
KS
Enumeration date
09/23/2005
Last updated
09/05/2008
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