DR. Wayne Michael Peterson, DMD

NPI #1235179466 in Moscow, Idaho

Provider Information

NPI Number: 1235179466
Entity Type: Individual
Name: DR. Wayne Michael Peterson, DMD
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Dentist - General Practice
Credential: DMD
Enumeration Date: Jun 7, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1138 W A ST
City: Moscow
State: Idaho
ZIP Code: 83843-2127
Phone: (208) 882-9310

Specialties & Taxonomy Codes

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

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