Provider Demographics
NPI:1932358488
Name:RUTHERFORD-PETERSON DENTISTRY LLC
Entity Type:Organization
Organization Name:RUTHERFORD-PETERSON DENTISTRY LLC
Other - Org Name:TOPEKA DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:P
Authorized Official - Last Name:RUTHERFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:785-266-9100
Mailing Address - Street 1:3316 SE 28TH TERRACE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66605
Mailing Address - Country:US
Mailing Address - Phone:785-266-9100
Mailing Address - Fax:785-266-7717
Practice Address - Street 1:3316 SE 28TH TERRACE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66605
Practice Address - Country:US
Practice Address - Phone:785-266-9100
Practice Address - Fax:785-266-7717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-09
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty