DR. Mark L Peterson, DDS

NPI #1689782864 in Rigby, Idaho

Provider Information

NPI Number: 1689782864
Entity Type: Individual
Name: DR. Mark L Peterson, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Aug 28, 2006
Last Updated: Jul 9, 2007

Practice Location

Address: 127 1/2 E SHORT ST
City: Rigby
State: Idaho
ZIP Code: 83442-1422
Phone: (208) 745-6536

Specialties & Taxonomy Codes

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

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