Individual
DR. THOMAS LAWRENCE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 S PRESTON ST, LOUISVILLE, KY 40202-1701
(502) 852-5128
Mailing address
2225 DOROTHY AVE APT 4, LOUISVILLE, KY 40205-1943
(478) 318-0129
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8811
KY
Other
Enumeration date
07/22/2009
Last updated
07/22/2009
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