# PETERSON DENTAL GROUP, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gentle Dental Tenaya
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316154669
- **Authorized official:** DR. BRADLEY R PETERSON DDS (PC PRESIDENT/OWNER)
- **Authorized official phone:** (360) 869-7645

## Contact information

- **Practice address:** 7260 W LAKE MEAD BLVD, \#5, LAS VEGAS, NV 89128-8388
- **Practice address phone:** (702) 869-0369
- **Practice address fax:** (702) 869-0643
- **Mailing address:** PO BOX 872710, VANCOUVER, WA 98687-2710
- **Mailing address phone:** (360) 869-7645
- **Mailing address fax:** (877) 725-7443

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 05/17/2007
- **Last updated:** 08/22/2025