# BRIAN R. PETERSON, D.D.S., PC

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

## Provider details

- **NPI number:** 1568635894
- **Authorized official:** DR. BRIAN ROBERT PETERSON D.D.S. (PRESIDENT)
- **Authorized official phone:** (480) 325-3368

## Contact information

- **Practice address:** 6812 E BROWN RD, SUITE 101, MESA, AZ 85207-3757
- **Practice address phone:** (480) 325-3368
- **Practice address fax:** (480) 325-0718
- **Mailing address:** 6812 E BROWN RD, SUITE 101, MESA, AZ 85207-3757
- **Mailing address phone:** (480) 325-3368
- **Mailing address fax:** (480) 325-0718

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5014 | AZ | Yes |

## Other

- **Enumeration date:** 04/08/2008
- **Last updated:** 04/08/2008