Individual
STEVEN R PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS SC
Contact information
Practice address
1700 TAINTER ST, SUITE A, MENOMONIE, WI 54751-8200
(715) 235-4291
(715) 235-4292
Mailing address
1700 TAINTER ST, SUITE A, MENOMONIE, WI 54751-8200
(715) 235-4291
(715) 235-4292
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6154-015
WI
Other
Enumeration date
04/23/2008
Last updated
05/26/2015
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