Dr. Russell Thomas Peterson, DDS
Dentist in Saint Cloud, MN. Individual provider (NPI-1).
NPI number1457513616
StatusActive
Last updated in NPPESMay 14, 2009
Details
- NPI
- 1457513616
- Entity type
- Individual (NPI-1)
- Name
- Dr. Russell Thomas Peterson
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 30, 2008
- Last updated
- May 14, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | D12530 | MN | Yes |
Practice location
816 W Saint Germain StSuite 101
Saint Cloud, MN 56301-4502
Phone 320-252-2454 · Fax 320-252-2232
Mailing address
816 W Saint Germain StSuite 101
Saint Cloud, MN 56301-4502
Phone 320-252-2454 · Fax 320-252-2232
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All 17 Dentist providers in Saint Cloud · All 4,526 providers in Saint Cloud
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