JASON M PETERSON

IDAHO FALLS, ID
NPI1225255748
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223P0300X Dentist, Periodontics
(Licence: ID  D3325PE)
Enumeration Date2007-04-18
Last Update Date2007-07-08
Business Address
-- JASON M PETERSON DDS
1980 1ST ST
IDAHO FALLS, ID 83401-4342
Phone number: 208-524-3400
Mailing Address
-- JASON M PETERSON DDS
1980 1ST ST
IDAHO FALLS, ID 83401-4342
Phone number: 208-524-3400
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