Individual
JANELLE C PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
7421 MEXICO RD STE 202, SAINT PETERS, MO 63376-1371
(636) 970-7902
Mailing address
12502 WINDSOR VIEW CT, ST. LOUIS, MO 63141
(314) 878-7832
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2000159662
MO
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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