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1407613425
JACOB DEAN PETERSON
CHEYENNE, WY
NPI
1407613425
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: WY 1679)
Enumeration Date
2024-03-05
Last Update Date
2024-07-10
Business Address
JACOB DEAN PETERSON DDS
1716 WARREN AVE
CHEYENNE, WY 82001-4538
Phone number: 307-632-0565
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Mailing Address
JACOB DEAN PETERSON DDS
510 STAR VALLEY DR
CHEYENNE, WY 82009-8552
Phone number: 307-221-8090
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