Individual
DAVID PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1619 BRANDYWINE LN, DIXON, IL 61021-8757
(815) 622-4740
Mailing address
1619 BRANDYWINE LN, DIXON, IL 61021-8757
(815) 622-4740
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
021001236
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019017734
LICENSE
IL
Enumeration date
09/12/2018
Last updated
09/12/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us