Individual
DR. MATHEW C PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2001 E LOHMAN AVE, STE 121, LAS CRUCES, NM 88001-3167
(575) 527-4746
Mailing address
2001 E LOHMAN AVE, STE 121, LAS CRUCES, NM 88001-3167
(575) 527-4746
(575) 524-7646
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD3330
NM
Other
Enumeration date
07/09/2010
Last updated
09/02/2011
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