DR. John Gregory Peterson, DMD

NPI #1295875953 in Boise, Idaho

Provider Information

NPI Number: 1295875953
Entity Type: Individual
Name: DR. John Gregory Peterson, DMD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Feb 8, 2007
Last Updated: Jul 8, 2007

Practice Location

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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