Organization
PETER P. DETTLAFF P. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER P. DETTLAFF O.D. (PRESIDENT)
(701) 839-8726
Entity
Organization
Contact information
Practice address
3900 S. BROADWAY ST., MINOT, ND 58701-7534
(701) 839-8726
(701) 858-1741
Mailing address
PO BOX 1165, WASHBURN, ND 58577-1165
(701) 462-8656
(701) 858-1741
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
399
ND
Other
Enumeration date
03/22/2007
Last updated
09/17/2007
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