Provider Demographics
NPI:1043245814
Name:HJORTH, PETER N (DMD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:N
Last Name:HJORTH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ESSEX CENTER DR
Mailing Address - Street 2:UNIT #210
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2904
Mailing Address - Country:US
Mailing Address - Phone:978-531-3010
Mailing Address - Fax:978-977-9828
Practice Address - Street 1:6 ESSEX CENTER DR
Practice Address - Street 2:UNIT #210
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2904
Practice Address - Country:US
Practice Address - Phone:978-531-3010
Practice Address - Fax:978-977-9828
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA167461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MABH0849616OtherDEA NUMBER