Jerry D Peterson

NPI #1417246414 in Frisco, Colorado

Provider Information

NPI Number: 1417246414
Entity Type: Individual
Name: Jerry D Peterson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Enumeration Date: Mar 31, 2011
Last Updated: Mar 31, 2011

Practice Location

Address: 360 PEAK ONE DR,
Address 2: SUITE 100
City: Frisco
State: Colorado
ZIP Code: 80443
Phone: (970) 668-4053

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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