| NPI | 1659582237 |
|---|---|
| Other Name | DAVID E. PETERSEN DDS |
| Entity Type | Organization |
| Authorized Contact | CORIE ANN SCHULTZ Senior Management 801-573-5572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |