Individual
LAURA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
373 W DRAKE RD, FORT COLLINS, CO 80526-2881
(970) 223-1166
Mailing address
373 W DRAKE RD, FORT COLLINS, CO 80526-2881
(970) 223-1166
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
000905893
CO
Other
Enumeration date
05/05/2014
Last updated
05/05/2014
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