PETERSEN DENTAL CLINIC PA NPI 1184835027

NPI Information

  • NPI: 1184835027
  • Provider Name: PETERSEN DENTAL CLINIC PA
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Doing Business As: ELKO-NEW MARKET DENTAL CLINIC
  • Address: 730 MAIN ST
    SUITE 2
    ELKO, MN
    ZIP 55020
  • Phone: (952) 461-5113

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NPI Details

PETERSEN DENTAL CLINIC PA is a general practice dentist in Elko, MN. 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. PETERSEN DENTAL CLINIC PA NPI is 1184835027. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Elko-new Market Dental Clinic.

The provider's business location address is:

730 MAIN ST
SUITE 2
ELKO, MN
ZIP 55020-701
Phone: (952) 461-5113

The provider's authorized official is Steven Blaine Petersen .
The authorized official title is Owner and has the following contact phone number (952) 461-5113.

The enumeration date for this NPI number is 5/24/2007 and was last updated on 7/15/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeD10525MINNESOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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