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Individual
DR. PETER LEWIS DORF
Active
Individual
DR. PETER LEWIS DORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019032231
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0401416731
VA
171000000X
Military Health Care Provider
01903321
IL
Other
Enumeration date
08/06/2019
Last updated
10/02/2024
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