WAYNE MICHAEL PETERSON

MOSCOW, ID
NPI1235179466
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: ID  D-1686)
Enumeration Date2006-06-07
Last Update Date2007-07-08
Business Address
Dr. WAYNE MICHAEL PETERSON DMD
1138 W A ST
MOSCOW, ID 83843-2127
Phone number: 208-882-9310
Mailing Address
Dr. WAYNE MICHAEL PETERSON DMD
1138 W A ST
MOSCOW, ID 83843-2127
Phone number: 208-882-9310
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