MICHAEL E PETERSON

BOISE, ID
NPI1942472691
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: ID  D-3044)
Enumeration Date2008-04-01
Last Update Date2008-04-01
Business Address
-- MICHAEL E PETERSON DDS
5355 W STATE ST
BOISE, ID 83703-3333
Phone number: 208-853-4687
Mailing Address
-- MICHAEL E PETERSON DDS
5355 W STATE ST
BOISE, ID 83703-3333
Phone number: 208-853-4687