Individual
DR. CRAIG ALBERT PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1504 4TH ST NE, WASECA, MN 56093
(507) 835-1080
(507) 835-1184
Mailing address
4 NICKOLAY LANE, GRAND MARAIS, MN 55604-5011
(218) 387-2038
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7460
MN
Other
Enumeration date
03/30/2007
Last updated
07/08/2007
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