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1215410584
DAVID PETERSON
DIXON, IL
NPI
1215410584
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223S0112X Dentist, Oral and Maxillofacial Surgery
(Licence: IL 021001236)
Enumeration Date
2018-09-12
Last Update Date
2018-09-12
Business Address
DAVID PETERSON dds
1619 BRANDYWINE LN
DIXON, IL 61021-8757
Phone number: 815-622-4740
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Mailing Address
DAVID PETERSON dds
1619 BRANDYWINE LN
DIXON, IL 61021-8757
Phone number: 815-622-4740
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