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Dr. Samuel Petersen, DMD
General Practice Dentistry in Eagle, Idaho
NPI 1720571284

Samuel Petersen is a General Practice Dentistry based in Eagle, ID and is specialized in General Practice. Samuel Petersen practices in Eagle, ID and has the professional credentials of DMD. The NPI Number for Samuel Petersen is 1720571284 and holds a License No. 10136 (Idaho).

The current practice location address for Samuel Petersen is 450 W State St Ste 115, Eagle, ID and can be reached out via phone at 208-370-5203 and via fax at 208-370-5204.

Location: 450 W State St Ste 115, Eagle, ID, 83616-7055
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1720571284
Provider Name
Samuel Petersen
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
450 W State St Ste 115, Eagle, ID, 83616-7055
Phone Number
208-370-5203
Fax Number
208-370-5204
Provider Enumeration Date
06/10/2018
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
450 W State St Ste 115
City
Eagle
State
Idaho
Zip
83616-7055
Phone Number
208-370-5203
Fax Number
208-370-5204
person
Provider Business Mailing Address Details
Address
450 W State St Ste 115
City
Eagle
State
Idaho
Zip
83616-7055
Phone Number
208-370-5203
Fax Number
208-370-5204
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
-
Taxonomy
122300000X
License No.
D-5038 (Idaho)
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
person
Provider's Taxonomy Details 2
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
10136 (Kentucky)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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