Bridget Leigh Petersen

NPI #1184044026 in Mattituck, New York

Provider Information

NPI Number: 1184044026
Entity Type: Individual
Name: Bridget Leigh Petersen
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Enumeration Date: Apr 18, 2014
Last Updated: Dec 3, 2015

Practice Location

Address: 11535 MAIN RD
City: Mattituck
State: New York
ZIP Code: 11952-1566
Phone: (631) 298-5021

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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