Individual
DR. BRUCE MICHAEL PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
607 DONNA WAY, SAN JACINTO, CA 92583-5517
(951) 654-0803
Mailing address
PO BOX 1189, ALHAMBRA, CA 91802-1189
(760) 668-0191
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
28064
CA
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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