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Organization
DANIEL PETERSEN DDS, INC.
Active
Organization
DANIEL PETERSEN DDS, INC.
Active
Other names
Riverside O.S.
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL W PETERSEN DDS (OWNER)
(530) 223-1811
Entity
Organization
Contact information
Practice address
316 KNOLLCREST DR, REDDING, CA 96002-0104
(530) 223-1811
(530) 223-1813
Mailing address
316 KNOLLCREST DR, REDDING, CA 96002-0104
(530) 223-1811
(530) 223-1813
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
57031
CA
Other
Enumeration date
12/02/2014
Last updated
12/02/2014
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