Individual
MR. JAMES G PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD,P.C.
Contact information
Practice address
607 NE 3RD ST, PRINEVILLE, OR 97754-2021
(541) 447-3855
(541) 416-9580
Mailing address
607 NE 3RD ST, PRINEVILLE, OR 97754-2021
(541) 447-3855
(541) 416-9580
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D5391
OR
Other
Enumeration date
07/07/2005
Last updated
07/08/2007
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