Individual
JEROMY A PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS PS
Contact information
Practice address
19301 8TH AVE NE, POULSBO, WA 98370
(360) 779-3958
(360) 779-3033
Mailing address
19301 8TH AVE NE, POULSBO, WA 98370-6200
(360) 779-3958
(360) 779-3033
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00008169
WA
Other
Enumeration date
09/02/2006
Last updated
05/30/2018
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