Individual
DR. GAIL E PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2526 CENTRAL AVE, COLUMBUS, IN 47201-3121
(812) 376-7263
Mailing address
2526 CENTRAL AVE, COLUMBUS, IN 47201-3121
(812) 376-7263
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10458
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200397400
—
IN
Enumeration date
07/27/2006
Last updated
10/27/2016
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