Petersen, Gerald D
Petersen, Gerald D is an individual health care provider with primary practice located at S22 W22660 East Broadway #2B , Waukesha WI 53186. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Petersen, Gerald D can be contacted via phone (262) 548-3555.Contact Information
Primary practice address
S22 W22660 East Broadway #2B
Waukesha WI 53186
Phone: (262) 548-3555
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 3340 | Wisconsin |
Profile Details
| NPI number | 1194922575 |
|---|---|
| LBN Legal business name | Petersen, Gerald D |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 29th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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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