DR. Grant Dee Petersen, D.D.S.
NPI #1790031128 in Fort Wainwright, Alaska
Provider Information
- NPI Number
- 1790031128
- Entity Type
- Individual
- Name
- DR. Grant Dee Petersen, D.D.S.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist
- Credential
- D.D.S.
- Enumeration Date
- Aug 3, 2012
- Last Updated
- Jul 16, 2013
Practice Location
- Address
- 1060 GAFFNEY RD STOP 7500
- City
- Fort Wainwright
- State
- Alaska
- ZIP Code
- 99703-5007
- Phone
- (907) 353-5530
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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