Individual
DR. DANIEL CHARLES PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
1550 30TH AVE S, MOORHEAD, MN 56560-5150
(218) 236-1322
Mailing address
1550 30TH AVE S, MOORHEAD, MN 56560-5150
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D14144
MN
Other
Enumeration date
03/06/2019
Last updated
03/06/2019
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