Individual
DUANE W. PEGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
509 SO. MONTESANO STREET, WESTPORT, WA 98595-2672
(360) 268-6225
(360) 268-6095
Mailing address
PO BOX 2672, WESTPORT, WA 98595-2672
(360) 268-6225
(360) 268-6095
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00008350
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145903
DEPT. OF L & I
WA
05
—
5047329
—
WA
Enumeration date
07/24/2006
Last updated
07/09/2007
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