Individual
DR. BENJAMIN T PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
271 SW 13TH ST, ONTARIO, OR 97914-4530
(541) 889-9407
(541) 889-6551
Mailing address
271 SW 13TH ST, ONTARIO, OR 97914-4530
(541) 889-9407
(541) 889-6551
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8413
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
231468
—
OR
Enumeration date
11/10/2006
Last updated
06/08/2023
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