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Organization

MICHAEL D PETERSON DDSMSPA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL DEAN PETERSON DDS (CORPORATE PRESIDENT)
(301) 754-0400
Entity
Organization

Contact information

Practice address
10301 GEORGIA AVE STE 202, SILVER SPRING, MD 20902-5020
(301) 754-0500
(301) 754-1220
Mailing address
10301 GEORGIA AVE STE 202, SILVER SPRING, MD 20902-5020
(301) 754-0500
(301) 754-1220

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
8004
MD

Other

Enumeration date
02/14/2007
Last updated
08/22/2020
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