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Individual
MR. PETER LA
Active
Individual
MR. PETER LA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
50932
NY
122300000X
Dentist
Primary
51952
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B5195201
HF PROGRAM
—
01
—
G9315301
DENTI CAL
—
Enumeration date
10/19/2006
Last updated
07/08/2007
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