Peterson Family Dentistry

NPI #1083873400 in Boise, Idaho

Provider Information

NPI Number: 1083873400
Entity Type: Organization
Organization Name: Peterson Family Dentistry
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 2, 2008
Last Updated: Jun 2, 2008

Practice Location

Address: 9201 W OVERLAND RD
City: Boise
State: Idaho
ZIP Code: 83709-2502
Phone: (208) 375-0185

Authorized Official

Name: DR. JOHN G PETERSON, DMD
Title: DENTIST
Phone: (208) 375-0185

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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