Dr. Benjamin T Peterson, DDS
Dentist, General Practice in Ontario, OR. Individual provider (NPI-1).
NPI number1720159080
StatusActive
Last updated in NPPESJun 8, 2023
Details
- NPI
- 1720159080
- Entity type
- Individual (NPI-1)
- Name
- Dr. Benjamin T Peterson
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Nov 10, 2006
- Certification date
- Jun 8, 2023
- Last updated
- Jun 8, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | D8413 | OR | Yes |
Practice location
271 Sw 13th StOntario, OR 97914-4530
Phone 541-889-9407 · Fax 541-889-6551
Mailing address
271 Sw 13th StOntario, OR 97914-4530
Phone 541-889-9407 · Fax 541-889-6551
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