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1457513616
RUSSELL THOMAS PETERSON
SAINT CLOUD, MN
NPI
1457513616
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: MN D12530)
Enumeration Date
2008-06-30
Last Update Date
2009-05-14
Business Address
Dr. RUSSELL THOMAS PETERSON DDS
816 W SAINT GERMAIN ST SUITE 101
SAINT CLOUD, MN 56301-4502
Phone number: 320-252-2454
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Mailing Address
Dr. RUSSELL THOMAS PETERSON DDS
816 W SAINT GERMAIN ST SUITE 101
SAINT CLOUD, MN 56301-4502
Phone number: 320-252-2454
Copy
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