Brody William Peterson, is a
Dentist based in Hettinger, North Dakota. Brody William Peterson is licensed to practice in North Dakota (license number 2472) and his current practice location is
204 Highway 12 E, Hettinger, North Dakota. He can be reached at his office (for appointments etc.) via phone at
(701) 567-4302.
NPI number for Brody William Peterson is 1588313134 and his current mailing address is 204 Highway 12 E, Hettinger, North Dakota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1588313134.
Healthcare Provider's Profile
| Full Name | Brody William Peterson |
|---|
| Gender | Male |
|---|
| Speciality | Dentist |
|---|
| Location | 204 Highway 12 E, Hettinger, North Dakota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1588313134
- Provider Enumeration Date: 03/21/2022
- Last Update Date: 06/30/2022
Medical Identifiers
Medical identifiers for Brody William Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1588313134 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | 2472 (North Dakota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brody William Peterson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Brody William Peterson,
204 Highway 12 E,
Hettinger, ND 58639-9687
Ph: () - | Brody William Peterson,
204 Highway 12 E,
Hettinger, ND 58639-9687
Ph: (701) 567-4302 |
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