Lillian Petersen, CDL, LD

NPI #1699198663 in Florence, Oregon

Provider Information

NPI Number
1699198663
Entity Type
Individual
Name
Lillian Petersen, CDL, LD
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Denturist
Credential
CDL, LD
Enumeration Date
Jan 28, 2014
Last Updated
Sep 23, 2014

Practice Location

Address
524 LAUREL STREET
State
Oregon
ZIP Code
97439-0004
Phone
(541) 997-6054

Specialties & Taxonomy Codes

Specialty
Denturist

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