Peterson, Stephan L

Peterson, Stephan L is an individual health care provider with primary practice located at 240 Locust St , Dover NH 03820. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Peterson, Stephan L can be contacted via phone (603) 742-6546.

Contact Information

Primary practice address
240 Locust St Dover NH 03820
Fax: (603) 742-7043
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 1725 New Hampshire

Profile Details

NPI number 1225197841
LBN Legal business name Peterson, Stephan L
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 8th, 2006
Last updated May 16th, 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 1225197841 NPPES
Other 0202034Y0NH01 FED BC BS
MEDICAID 89192034 FED BC BS
Other 139950000 FED BC BS

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