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General NPI Number Information
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NPI Number | 1730234576
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Entity Type | Organization
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Legal Business Name | RICHARD A. PEURA DDS PC
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 04/22/2009
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Provider Practice Location Address
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Address Line | 708 CHIPPEWA SQUARE SUITE #1
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City | MARQUETTE
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State | MI
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Zip | 49855-4814
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Country | US
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Telephone | 906-228-9594
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Fax | 906-228-9196
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Provider Business Mailing Address
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Address Line | 708 CHIPPEWA SQ SUITE #1
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City | MARQUETTE
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State | MI
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Zip | 49855-4814
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Country | US
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Telephone | 906-228-9594
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Fax | 906-228-9196
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD A. PEURA
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Credential | DDS
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Telephone | 906-228-9594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | MM015901
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | MS19101
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | RP010017
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License Number State | MI
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