Peterson, Mark Edward
Peterson, Mark Edward is an sole proprietor health care provider with primary practice located at 2440 Gaynor Nw , Grand Rapids MI 49544-1830. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Peterson, Mark Edward can be contacted via phone (616) 784-8444.Contact Information
Primary practice address
2440 Gaynor Nw
Grand Rapids MI 49544-1830
Phone: (616) 784-8444
Fax: (616) 784-6912
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 13556 | Michigan |
Profile Details
| NPI number | 1528013661 |
|---|---|
| LBN Legal business name | Peterson, Mark Edward |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 24th, 2006 |
| Last updated | Mar 14th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528013661 | NPPES |
| Michigan | MEDICAID | 124241245 | |
| Michigan | Other | D135560 |
Popular Providers
-
Mccoy, Steven
1500 44Th St Se , Grand Rapids MI 49508-4651 -
Osenieks, Mark Allan
O-11225 Tallmadge Woods Dr Nw , Grand Rapids MI 49534-6313 -
Spring, Roger F
2003 Burton St Se , Grand Rapids MI 49506-4600 -
Doezema, C Philip
2003 Burton Se , Grand Rapids MI 49506-4600 -
Vanderlugt, David F
2008 Eastcastle Dr Se Suite C, Grand Rapids MI 49508-8874 -
Wilson, Kathi Ann
1625 Diamond Ave Ne , Grand Rapids MI 49505-4887 -
Frieswyk, Kenneth E
2740 Eastern Ave Se , Grand Rapids MI 49507-3643 -
Mehling, Michael Vincent
2700 5 Mile Rd Ne Ste 201 , Grand Rapids MI 49525-6516