Individual
TREVOR PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4411 BROWNRIDGE TERRACE, MEDFORD, OR 97504
(541) 200-6747
Mailing address
4411 BROWNRIDGE TERRACE, MEDFORD, OR 97504
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10235
OR
Other
Enumeration date
06/04/2015
Last updated
06/04/2015
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