DR. Samuel Petersen, DMD is a general practice dentist in Eagle, ID. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Samuel Petersen, DMD NPI is 1720571284. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
450 W STATE ST STE 115
EAGLE, ID
ZIP 83616-055
Phone: (208) 370-5203
Fax: (208) 370-5204
The NPI 1720571284 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).
The enumeration date for this NPI number is 6/10/2018 and was last updated on 2/28/2024.