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Contact Information

TREVOR PETERSON, DMD
4411 BROWNRIDGE TERRACE
MEDFORD, OR97504
 Phone: 541-200-6747
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for TREVOR PETERSON · (Male)

NPI # 1275913329
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 06/04/2015
Last updated 06/04/2015 - About 11 years ago
Sole proprietor 1 Yes
Identifiers
  • OR License # D10235
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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