Peterson, Gary Ray

Peterson, Gary Ray is an individual health care provider with primary practice located at 3815 Stephens Ave , Missoula MT 59801-8505. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Peterson, Gary Ray can be contacted via phone (406) 728-0200.

Contact Information

Primary practice address
3815 Stephens Ave Missoula MT 59801-8505
Phone: (406) 728-0200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 1359 Montana

Profile Details

NPI number 1285799304
LBN Legal business name Peterson, Gary Ray
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2006
Last updated Apr 13th, 2016 - about 10 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 1285799304 NPPES
Montana MEDICAID 0120037

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