Individual
AUDREY LAUREN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
5277 COLLEGE AVE STE 203, OAKLAND, CA 94618-1437
(510) 654-2226
(510) 595-1455
Mailing address
5277 COLLEGE AVE STE 203, OAKLAND, CA 94618-1437
(510) 654-2226
(510) 595-1455
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
58443
CA
Other
Enumeration date
10/16/2009
Last updated
10/16/2009
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