Peterson, Kelsey
Peterson, Kelsey is an sole proprietor health care provider with primary practice located at 1312 South Washington Street , Emmett ID 83617. He recently has 2 registered licenses in different health care specialties including Dental Providers / Orthodontics and Dentofacial Orthopedics, Dental Providers / General Practice. Dental Providers / General Practice is his primary health care specialty. Peterson, Kelsey can be contacted via phone (208) 941-6640.Contact Information
Primary practice address
1312 South Washington Street
Emmett ID 83617
Phone: (208) 941-6640
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | D-4282-OR | Idaho |
| Dental Providers / General Practice | 1223G0001X | D-4282 | Idaho |
Profile Details
| NPI number | 1396069712 |
|---|---|
| LBN Legal business name | Peterson, Kelsey |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 15th, 2010 |
| Last updated | Feb 13th, 2024 - about 2 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.
Popular Providers
-
Bienenstock, Marc Irwin
3809 Junction Blvd Fl 2, Corona NY 11368-2153 -
Walsh, Douglas Paul
9801 17Th Ave Sw , Seattle WA 98106-2759 -
Willis, Warren Richard
119 N Wardwell Ave , Emmett ID 83617-3040 -
Duran, Daniel A.
2974 N Main St , Las Cruces NM 88001-1152 -
Winn, Frank O.
4551 Gautier Vancleave Rd Ste A, Gautier MS 39553-4810 -
Wallace, Darren K
2003 E Quail Run Rd , Emmett ID 83617-5059 -
Wallace, Andrea L
2003 S Plaza Rd , Emmett ID 83617-9180 -
Raiber, Robert Brian
630 5Th Ave , New York NY 10111-0100