Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Ronald Lee Petersen, DDS

Individual provider Dentist · NPI 1194830760

Mr. Ronald Lee Petersen, DDS is a Dentist in Charleston, Missouri. Licensed in Missouri. Registered with an NPI since 2006.

Licensed in
MO
In the registry since
2006
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

104 N Main St
Charleston, MO 63834
Phone: (573) 683-2101
Fax: (573) 683-2102
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 014068 (MO)

Record details

NPI number1194830760
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedAugust 21, 2006
Last updated in NPPESJuly 8, 2007