WAYNE PETERSON DMD PC

MOSCOW, ID
NPI1134389281
Entity TypeOrganization
Authorized ContactWAYNE MICHAEL PETERSON
President
208-882-9310
Organization Subpart ?No
Primary Taxonomy122300000X Dentist
(Licence: ID  D1686)
Enumeration Date2008-06-12
Last Update Date2008-06-12
Business Address
WAYNE PETERSON DMD PC
1138 WEST A ST
MOSCOW, ID 83843
Phone number: 208-882-9310
Mailing Address
WAYNE PETERSON DMD PC
1138 WEST A ST
MOSCOW, ID 83843
Phone number: 208-882-9310
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