Individual
PETER J MAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS,MD
Contact information
Practice address
3617 W ARROWHEAD RD, DULUTH, MN 55811-4046
(218) 722-8377
(218) 722-3117
Mailing address
3617 W ARROWHEAD RD, DULUTH, MN 55811-4046
(218) 722-8377
(218) 722-3117
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
5846
WI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D12064
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
336G1MA
MINNESOTA BCBS
MN
01
—
33793800
WISCONSIN MEDICAID
WI
Enumeration date
01/10/2007
Last updated
03/05/2008
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