Russell Thomas Peterson, DDS

Dentist · Saint Cloud, MN

Individual Active NPI

NPI number 1457513616

Practice location

816 W Saint Germain St
Suite 101
Saint Cloud, MN 56301-4502
Phone
(320) 252-2454
Fax
(320) 252-2232

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NPI record

NPI
1457513616
Entity type
Individual (Type 1)
Enumeration date
June 30, 2008
Last updated
May 14, 2009
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X D12530 MN

About Dr. Peterson

Russell Thomas Peterson, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 816 W Saint Germain St, Suite 101, Saint Cloud, MN 56301-4502. The NPI number 1457513616 was assigned on June 30, 2008 and the record was last updated on May 14, 2009.

Dr. Peterson lists a license in the registry: #D12530 (MN) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Russell Thomas Peterson, DDS?

The NPI number is 1457513616.

What is the phone number of Dr. Peterson?

The phone number listed for the practice location is (320) 252-2454.

Where is Dr. Peterson located?

816 W Saint Germain St, Suite 101, Saint Cloud, MN 56301-4502.

What is the taxonomy code for Dr. Peterson?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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