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1477566198
BYRON THAD PETERSEN
SALT LAKE CITY, UT
NPI
1477566198
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: UT 135438-9923)
Enumeration Date
2006-08-14
Last Update Date
2007-07-08
Business Address
Dr. BYRON THAD PETERSEN d.d.s.
GEORGE E WAHLEN DEPT OF VETERANS AFFAIRS MEDICAL CTR 500 FOOTHILL DRIVE, DENTAL SERVICE (160)
SALT LAKE CITY, UT 84148-0001
Phone number: 801-584-1206
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Mailing Address
Dr. BYRON THAD PETERSEN d.d.s.
2162 E. CREEK ROAD
SANDY, UT 84093-6448
Phone number: 801-942-2631
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