Nicholas Dee Petersen, DDS

NPI #1912790965 in Provo, Utah

Provider Information

NPI Number: 1912790965
Entity Type: Individual
Name: Nicholas Dee Petersen, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: May 23, 2025
Last Updated: May 23, 2025

Practice Location

Address: 1234 N 900 E STE 100
City: Provo
State: Utah
ZIP Code: 84604-2726
Phone: (801) 854-9140

Specialties & Taxonomy Codes

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

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