Dr Mark S Petersen, DDS is a
Dentist - General Practice based in Coxsackie, New York. Dr Mark S Petersen is licensed to practice in New York (license number 036653) and his current practice location is
7 Elm St, Coxsackie, New York. He can be reached at his office (for appointments etc.) via phone at
(518) 731-2797.
NPI number for Dr Mark S Petersen is 1255470365 and his current mailing address is 331 Chapel Rd, Gilboa, New York. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1255470365.
Healthcare Provider's Profile
| Full Name | Dr Mark S Petersen |
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| Gender | Male |
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| Speciality | Dentist - General Practice |
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| Location | 7 Elm St, Coxsackie, New York |
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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: 1255470365
- Provider Enumeration Date: 02/05/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Dr Mark S Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1255470365 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | 036653 (New York) | 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. Dr Mark S Petersen 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 |
|---|
Dr Mark S Petersen, DDS
331 Chapel Rd,
Gilboa, NY 12076-2613
Ph: () - | Dr Mark S Petersen, DDS
7 Elm St,
Coxsackie, NY 12051-1301
Ph: (518) 731-2797 |
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