DAVID PETERSON

DIXON, IL
NPI1215410584
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: IL  021001236)
Enumeration Date2018-09-12
Last Update Date2018-09-12
Business Address
DAVID PETERSON dds
1619 BRANDYWINE LN
DIXON, IL 61021-8757
Phone number: 815-622-4740
Mailing Address
DAVID PETERSON dds
1619 BRANDYWINE LN
DIXON, IL 61021-8757
Phone number: 815-622-4740