Individual
DR. STEVEN BLAINE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9202 202ND ST W, SUITE 201, LAKEVILLE, MN 55044-7915
(952) 469-2818
(952) 469-2566
Mailing address
9202 202ND ST W, SUITE 201, LAKEVILLE, MN 55044-7915
(952) 469-2818
(952) 469-2566
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10525
MN
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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