Daniel Bryce Petersen, D.M.D.
NPI #1003498825 in Shaw Afb, South Carolina
Provider Information
- NPI Number
- 1003498825
- Entity Type
- Individual
- Name
- Daniel Bryce Petersen, D.M.D.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist
- Credential
- D.M.D.
- Enumeration Date
- Apr 21, 2021
- Last Updated
- Nov 25, 2024
Practice Location
- Address
- 420 POLIFKA DR BLDG 1042
- City
- Shaw Afb
- State
- South Carolina
- ZIP Code
- 29152-5100
- Phone
- (803) 895-6951
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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