Individual
DR. KRISTY LYNN PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
10150 CITY WALK DR APT C, WOODBURY, MN 55129-9270
(651) 714-5555
Mailing address
10150 CITY WALK DR APT C, WOODBURY, MN 55129-9270
(651) 714-5555
(651) 714-9005
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
5884015
WI
122300000X
Dentist
Primary
D12087
MN
Other
Enumeration date
09/29/2006
Last updated
01/10/2018
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