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Individual
MANFRED HENRY PETERS JR.
Active
Individual
MANFRED HENRY PETERS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10881
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
89D682
BLUE CROSS BLUE SHIELD #
TX
01
—
B10881-01
TEXAS CHIPS
TX
Enumeration date
10/23/2006
Last updated
07/08/2007
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