Individual
DR. ALAN CLARK PETERSON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
601 MCDONOUGH BLVD SE, ATLANTA, GA 30315-4400
(404) 635-5462
Mailing address
601 MCDONOUGH BLVD SE, ATLANTA, GA 30315-4400
(404) 635-5462
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
015796
MO
Other
Enumeration date
07/11/2016
Last updated
07/11/2016
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