JAKE ALLEN PETERSON

BEND, OR
NPI1043657364
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: ID  D-5107-OS)
Additional Taxonomies1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: ID  m-15171)
1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: WA  DE60941667)
Enumeration Date2013-05-28
Last Update Date2022-03-01
Business Address
JAKE ALLEN PETERSON DDS, MD
1475 SW CHANDLER AVE STE 101
BEND, OR 97702-3239
Phone number: 541-617-3993
Mailing Address
JAKE ALLEN PETERSON DDS, MD
1475 SW CHANDLER AVE STE 101
BEND, OR 97702-3239
Phone number: 541-617-3993