Individual
JAMIE LEE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5400 140TH AVE NW STE 104, RAMSEY, MN 55303-3949
(763) 427-8117
Mailing address
5400 140TH AVE NW STE 104, RAMSEY, MN 55303-3949
(763) 427-8117
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D14171
MN
Other
Enumeration date
05/17/2019
Last updated
10/25/2023
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