| Peterson Dental Pa | |
|
1579 Hamline Ave N Saint Paul MN 55108-6119 | |
| (651) 646-8851 | |
| (651) 646-4477 |
| Full Name | Peterson Dental Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 1579 Hamline Ave N, Saint Paul, Minnesota |
| Authorized Official Name and Position | Donald Peterson (OWNER) |
| Authorized Official Contact | 6516468851 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peterson Dental Pa 1579 Hamline Ave N Saint Paul MN 55108-6119 Ph: (651) 646-8851 | Peterson Dental Pa 1579 Hamline Ave N Saint Paul MN 55108-6119 Ph: (651) 646-8851 |
| NPI Number | 1669046199 |
|---|---|
| Provider Enumeration Date | 05/19/2021 |
| Last Update Date | 05/19/2021 |
| Medicare PECOS PAC ID | 5890196059 |
|---|---|
| Medicare Enrollment ID | O20210624002625 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669046199 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Tara V Brodersen |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1336138882 PECOS PAC ID: 3274825542 Enrollment ID: I20190215001839 |
Dr, David Nelson Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1439 Arcade St, Saint Paul, MN 55106 Phone: 651-776-4835 | |
Associated Dentists Sholom Home Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1371 7th St W, Suite B, Saint Paul, MN 55102 Phone: 651-488-5557 Fax: 651-488-0014 | |
Family & Cosmetic Gentle Dentistry, Ltd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1680 Suburban Ave, Saint Paul, MN 55106 Phone: 651-209-3139 Fax: 651-209-3138 | |
Signature Orthodontics, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1575 7th St W Ste 102, Saint Paul, MN 55102 Phone: 651-426-9986 | |
Milk And Honey Dental Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 50 County Road B E, Saint Paul, MN 55117 Phone: 651-488-2541 | |
Peterson & Peterson Dds Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1224 Arcade St, Saint Paul, MN 55106 Phone: 651-774-2959 Fax: 651-774-1997 | |
Main Street Family Dental Care P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 411 Main St, Suite 308, Saint Paul, MN 55102 Phone: 651-227-6561 Fax: 651-297-6852 |