Edwin Roy Peterson, DDS

NPI #1922012061 in Nevada, Missouri

Provider Information

NPI Number: 1922012061
Entity Type: Individual
Name: Edwin Roy Peterson, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Jul 27, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 629 S MAIN ST
City: Nevada
State: Missouri
ZIP Code: 64772-3555
Phone: (417) 667-3134

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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