Lorin Dean Peterson
Oral and Maxillofacial Pathology
77 W Forest Ave Ste 107
Flagstaff
, Arizona 86001-1482
Lorin Dean Peterson
Oral and Maxillofacial Pathology
77 W Forest Ave Ste 107
Flagstaff
, Arizona 86001-1482
(928) 773-2532
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About
Features
Specialties
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Lorin Dean Peterson
- 77 W Forest Ave Ste 107
- Flagstaff, AZ
- Zip : 86001-1482
- Fax : (928) 773-2532
- Phone : (928) 773-2530
Second Address
- Lorin Dean Peterson
- 77 W Forest Ave Ste 107
- Flagstaff, AZ
- Zip : 86001-1482
- Fax : (928) 773-2532
- Phone : (928) 773-2530
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | 2803 | AZ |
National Provider Identifier
| NPI | 1699772061 |
|---|---|
| Provider Name | Lorin Dean Peterson |
| First Address | Flagstaff, AZ 86001-1482 |
| Second Address | Flagstaff, AZ 86001-1482 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/06/2005 |
| Last Update Date | 17/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 086373 | (05) | AZ |
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.