Individual
DR. KYLE W. PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
609 22ND ST, MOLINE, IL 61265-1450
(309) 797-2001
Mailing address
609 22ND ST, MOLINE, IL 61265-1450
(309) 797-2001
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
08753
IA
Other
Enumeration date
07/20/2010
Last updated
09/21/2011
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