Dr. Troy R Petersen
Oral and Maxillofacial Surgeon
1165c South Columbia Road
Grand Forks
, North Dakota 58201-4007
Dr. Troy R Petersen
Oral and Maxillofacial Surgeon
1165c South Columbia Road
Grand Forks
, North Dakota 58201-4007
(701) 772-9643
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Troy R Petersen
- 1165c South Columbia Road
- Grand Forks, ND
- Zip : 58201-4007
- Fax : (701) 772-9643
- Phone : (701) 772-7379
Second Address
- Dr. Troy R Petersen
- 1165c South Columbia Road
- Grand Forks, ND
- Zip : 58201-4007
- Fax : (701) 772-9643
- Phone : (701) 772-7379
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | 1897 | ND |
National Provider Identifier
| NPI | 1073697157 |
|---|---|
| Provider Name | Dr. Troy R Petersen |
| First Address | Grand Forks, ND 58201-4007 |
| Second Address | Grand Forks, ND 58201-4007 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/10/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 12975 | (05) | ND |
| 252L7PE | BCBS (01) | MN |
| I03250 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.