Organization
ANDREW M PETERSEN, DDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW MARVIN PETERSEN DDS (OWNER)
(480) 893-7733
Entity
Organization
Contact information
Practice address
4802 E RAY RD, SUITE #19, PHOENIX, AZ 85044-6405
(480) 893-7733
Mailing address
4802 E RAY RD, SUITE #19, PHOENIX, AZ 85044-6405
(480) 893-7733
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7013
AZ
Other
Enumeration date
06/25/2008
Last updated
06/25/2008
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