# TYR R. PETERSON, D.D.S., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194914218
- **Authorized official:** DR. TYR R. PETERSON D.D.S. (PRESIDENT)
- **Authorized official phone:** (303) 424-6483

## Contact information

- **Practice address:** 5400 WARD ROAD, BUILDING II, SUITE 100, ARVADA, CO 80002-1819
- **Practice address phone:** (303) 424-6483
- **Mailing address:** 5400 WARD ROAD, BUILDING II, SUITE 100, ARVADA, CO 80002-1819
- **Mailing address phone:** (303) 424-6483

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 7993 | CO | Yes |

## Other

- **Enumeration date:** 10/15/2007
- **Last updated:** 08/19/2013