Individual
DR. DANIEL ALLEN PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7223 W CLEARWATER AVE, KENNEWICK, WA 99336
(509) 783-8822
(509) 783-1983
Mailing address
7223 W CLEARWATER AVE, KENNEWICK, WA 99336
(509) 783-8822
(509) 783-1983
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00006331
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5012711
—
WA
01
—
5871PE
BLUE CROSS
—
01
—
685412
UNITED CONCORDIA
—
01
—
75693
WDS DELTA
—
Enumeration date
03/17/2006
Last updated
10/04/2013
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