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Individual

DR. JUSTIN SCOTT PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
7321 BALMER ST BLDG 570, HILL AFB, UT 84056-5012
(801) 777-7011
Mailing address
7321 BALMER ST BLDG 570, HILL AFB, UT 84056-5012

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN.00205577
CO
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/17/2023
Last updated
08/22/2024
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