Individual
DR. DANE M PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2601 39TH AVE NE STE 1, ST. ANTHONY, MN 55421-4372
(763) 416-7600
(763) 416-7634
Mailing address
8401 GOLDEN VALLEY RD STE 330, GOLDEN VALLEY, MN 55427-4488
(763) 416-7629
(763) 383-4147
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2738
CO
152W00000X
Optometrist
Primary
3325
MN
Other
Enumeration date
07/08/2009
Last updated
03/17/2020
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