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Joshua Petersen Valid NPI

Individual provider · General Practice Dentistry · Rapid City, SD

NPI
1508424680
Type
Individual (Type 1)
Primary specialty
General Practice Dentistry (Dentist)
Specialty group
Dental Providers
Taxonomy code
1223G0001X
License number
D1231 (SD)
Sex
Male
Sole proprietor
No
Enumerated
2019-06-03
Last updated
2019-06-03
Practice location
1687 Tablerock Rd
Rapid City, SD 57701-5495
(605) 342-6652

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