Organization
HOMETOWN DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS PETERS DMD (OWNER)
(701) 590-3445
Entity
Organization
Contact information
Practice address
188 OSBORN DR, DICKINSON, ND 58601-3960
(701) 483-7668
Mailing address
188 OSBORN DR, DICKINSON, ND 58601-3960
(701) 483-7668
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1483355
—
ND
01
—
4572184
UCCI DENTAL CLAIMS (BCBS)
ND
Enumeration date
01/05/2022
Last updated
01/05/2022
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