Individual
DR. KARL JOHN PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1815 SUBURBAN AVE, SAINT PAUL, MN 55119-4302
(507) 285-0449
Mailing address
3031 42ND AVE S, MINNEAPOLIS, MN 55406-2238
(507) 285-0449
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D13822
MN
Other
Enumeration date
05/17/2017
Last updated
05/17/2017
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