| Dr Samuel Petersen, DMD | |
|
450 W State St Ste 115, Eagle, ID 83616-7055 | |
| (208) 370-5203 | |
| (208) 370-5204 |
| Full Name | Dr Samuel Petersen |
|---|---|
| Gender | Male |
| Speciality | Dentist - General Practice |
| Location | 450 W State St Ste 115, Eagle, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720571284 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 10136 (Kentucky) | Secondary |
| 1223G0001X | Dentist - General Practice | D-5038 (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Samuel Petersen, DMD 450 W State St Ste 115, Eagle, ID 83616-7055 Ph: (208) 370-5203 | Dr Samuel Petersen, DMD 450 W State St Ste 115, Eagle, ID 83616-7055 Ph: (208) 370-5203 |
Dr. Evan Hathaway, DDS Dentist Medicare: Medicare Enrolled Practice Location: 1217 E Iron Eagle Dr, Eagle, ID 83616 Phone: 208-377-1161 Fax: 208-938-0567 | |
Colton Charles, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 450 W State St Ste 180, Eagle, ID 83616 Phone: 208-939-0600 | |
Dr. Joel Edward Courtial, DDS Dentist Medicare: Medicare Enrolled Practice Location: 151 Stierman Way, Eagle, ID 83616 Phone: 208-939-4111 Fax: 208-939-3701 | |
George D. Chen, DDS Dentist Medicare: Medicare Enrolled Practice Location: 1564 E Crowne Point Dr, Eagle, ID 83616 Phone: 916-508-2435 Fax: 916-983-6201 | |
Dr. Michael G Dolby, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 90 Cottonwood Ct Ste 100, Eagle, ID 83616 Phone: 208-323-8545 Fax: 208-938-1401 | |
Donald E Larson, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 700 E State St Ste 100, Eagle, ID 83616 Phone: 208-939-3500 Fax: 208-939-9897 | |
Dr. Ryan N Van Alfen, DDS, PLC Dentist Medicare: Not Enrolled in Medicare Practice Location: 483 S Rivershore Ln Ste 102, Eagle, ID 83616 Phone: 208-938-2100 Fax: 208-938-0676 |