IndividualActive
Elisabeth Peterson, DDS
NPI 1508094244 · Oral and Maxillofacial Surgery (Dentist) · St. Paul, MN
Provider details
- NPI number
- 1508094244
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Credential
- DDS
- Sex
- Female
- Sole proprietor
- No
- License
- D12105 (MN)
Specialties & taxonomies
Dental Providers
Practice location
2500 Como Avenue
St. Paul, MN 55108-1460
Phone: (651) 999-4600
Fax: (651) 632-8984
Approximate (ZIP-level) locationGet directions
Mailing address
2500 Como Avenue
St. Paul, MN 55108-1460
Registry dates
- Enumerated
- 2009-07-01
- Last updated
- 2012-03-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.