Organization
DALLAS PETERSON MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA MARIE CROWE (ADMINISTRATOR)
(928) 537-7011
Entity
Organization
Contact information
Practice address
3401 LOCKWOOD DR, LAKESIDE, AZ 85929-5613
(928) 368-2060
Mailing address
1600 S WHITE MOUNTAIN RD, SHOW LOW, AZ 85901-7106
(928) 537-7011
(928) 251-1063
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AZ23268
AZ
Other
Enumeration date
08/21/2010
Last updated
08/21/2010
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