# PETERSON DENTAL

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

## Provider details

- **NPI number:** 1841746476
- **Authorized official:** DR. KURT PETERSON DDS (OWNER)
- **Authorized official phone:** (509) 747-2183

## Contact information

- **Practice address:** 1604 W RIVERSIDE AVE, SPOKANE, WA 99201-1206
- **Practice address phone:** (509) 747-2183
- **Practice address fax:** (509) 747-3990
- **Mailing address:** 1604 W RIVERSIDE AVE, SPOKANE, WA 99201-1206
- **Mailing address phone:** (509) 747-2183
- **Mailing address fax:** (509) 747-3990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 5608 | WA | Yes |

## Other

- **Enumeration date:** 09/01/2016
- **Last updated:** 09/01/2016