Petersen, Lillian
Petersen, Lillian is an sole proprietor health care provider with primary practice located at 524 Laurel Street , Florence OR 97439-0004. She recently has only one registered license in Dental Providers / Denturist, which is considered as her primary health care specialty. Petersen, Lillian can be contacted via phone (541) 997-6054.Contact Information
Primary practice address
524 Laurel Street
Florence OR 97439-0004
Phone: (541) 997-6054
Fax: (541) 997-6054
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Denturist | 122400000X | DT DO 706283 | Oregon |
Profile Details
| NPI number | 1699198663 |
|---|---|
| LBN Legal business name | Petersen, Lillian |
| Credentials | CDL, LD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 28th, 2014 |
| Last updated | Sep 23rd, 2014 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699198663 | NPPES |
| Oregon | Other | 122400000X | DENTURIST |
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