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1942472691
MICHAEL E PETERSON
BOISE, ID
NPI
1942472691
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: ID D-3044)
Enumeration Date
2008-04-01
Last Update Date
2008-04-01
Business Address
-- MICHAEL E PETERSON DDS
5355 W STATE ST
BOISE, ID 83703-3333
Phone number: 208-853-4687
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Mailing Address
-- MICHAEL E PETERSON DDS
5355 W STATE ST
BOISE, ID 83703-3333
Phone number: 208-853-4687
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