Petersen, Joshua

Petersen, Joshua is an individual health care provider with primary practice located at 1687 Tablerock Rd , Rapid City SD 57701-5495. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Petersen, Joshua can be contacted via phone (605) 342-6652.

Contact Information

Primary practice address
1687 Tablerock Rd Rapid City SD 57701-5495
Phone: (605) 342-6652
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D1231 South Dakota

Profile Details

NPI number 1508424680
LBN Legal business name Petersen, Joshua
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 3rd, 2019
Last updated Jun 3rd, 2019 - about 7 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 1508424680 NPPES
South Dakota Other D1231 LICENSE

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