Dr. Dane M Peterson, OD
Optometrist in St. Anthony, MN. Individual provider (NPI-1).
NPI number1285863530
StatusActive
Last updated in NPPESMar 17, 2020
Details
- NPI
- 1285863530
- Entity type
- Individual (NPI-1)
- Name
- Dr. Dane M Peterson
- Credential
- OD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 8, 2009
- Certification date
- Mar 17, 2020
- Last updated
- Mar 17, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 3325 | MN | Yes |
| 152W00000X | Optometrist | 2738 | CO |
Practice location
2601 39th Ave Ne Ste 1St. Anthony, MN 55421-4372
Phone 763-416-7600 · Fax 763-416-7634
Mailing address
8401 Golden Valley Rd Ste 330Golden Valley, MN 55427-4488
Phone 763-416-7629 · Fax 763-383-4147
Other practice locations
8501 Golden Valley Rd Ste 100
Golden Valley, MN 55427-4472
Golden Valley, MN 55427-4472
Phone 763-416-7600 · Fax 763-416-7634
12000 Elm Creek Blvd N Ste 100
Maple Grove, MN 55369-7074
Maple Grove, MN 55369-7074
Phone 763-416-7600 · Fax 763-416-7634
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