Petersen, Daniel Allen

Petersen, Daniel Allen is an individual health care provider with primary practice located at 7223 W Clearwater Ave , Kennewick WA 99336. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Petersen, Daniel Allen can be contacted via phone (509) 783-8822.

Contact Information

Primary practice address
7223 W Clearwater Ave Kennewick WA 99336
Phone: (509) 783-8822
Fax: (509) 783-1983
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DE00006331 Washington

Profile Details

NPI number 1083673271
LBN Legal business name Petersen, Daniel Allen
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2006
Last updated Oct 4th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083673271 NPPES
Other 5871PE BLUE CROSS
Other 685412 BLUE CROSS
Other 75693 BLUE CROSS
MEDICAID 5012711 BLUE CROSS

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