Individual
DR. TARA SKELLY PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
9042 CAHILL AVE, INVER GROVE HEIGHTS, MN 55076-3543
(651) 457-8282
Mailing address
4663 PARKRIDGE DR, EAGAN, MN 55123-2130
(651) 587-8844
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13973
MN
Other
Enumeration date
05/14/2018
Last updated
05/14/2018
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