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1003170531
BETHANY ANNE PETERSEN
AUSTIN, TX
NPI
1003170531
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: TX 28004)
Enumeration Date
2012-06-29
Last Update Date
2012-06-29
Business Address
-- BETHANY ANNE PETERSEN DDS
4410 E RIVERSIDE DR STE 150
AUSTIN, TX 78741-4759
Phone number: 855-512-7625
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Mailing Address
-- BETHANY ANNE PETERSEN DDS
1620 E RIVERSIDE DR APT 4034
AUSTIN, TX 78741-1026
Phone number: 713-492-7719
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