Individual
DR. MICHAEL DEAN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
4710 AMBER VALLEY PKWY S, STE A, FARGO, ND 58104
(701) 232-1956
(701) 232-2226
Mailing address
4710 AMBER VALLEY PKWY S, STE A, FARGO, ND 58104
(701) 232-1956
(701) 232-2226
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
8004
MD
Other
Enumeration date
10/14/2011
Last updated
07/10/2012
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