Individual
DR. MONICA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
608 B STREET WEST, RAINIER, OR 97048
(503) 556-0002
Mailing address
4730 N AMHERST ST, PORTLAND, OR 97203-4775
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8981
OR
Other
Enumeration date
11/13/2007
Last updated
05/22/2008
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