TAYNE A PETERSON DMD PLLC

BURLEY, ID
NPI1942936406
Entity TypeOrganization
Authorized ContactTAYNE PETERSON
Sole Mbr
208-670-4428
Organization Subpart ?No
Primary Taxonomy261QD0000X Clinic/Center Dental
Enumeration Date2022-07-27
Last Update Date2022-09-07
Business Address
TAYNE A PETERSON DMD PLLC
2200 PARK AVE STE 2
BURLEY, ID 83318-2186
Phone number: 208-878-6684
Mailing Address
TAYNE A PETERSON DMD PLLC
2200 PARK AVE STE 2
BURLEY, ID 83318-2186
Phone number: 208-878-6684
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