NPI 1073697157

Troy R Petersen, DMDMD

Practitioner Oral and Maxillofacial Surgery (Dentist) Grand Forks, ND

Practice location

Address: 1165c South Columbia Road, Grand Forks, ND 58201-4007
Phone: (701) 772-7379
Fax: (701) 772-9643

Registered specialties

Oral and Maxillofacial Surgery (Dentist) Primary

Dental Providers Taxonomy 1223S0112X Licence 1897 (ND)

Other Dentist providers in North Dakota →

Registry record

NPI: 1073697157
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Oct 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.