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Organization

PETER C. KNUDSON DDS, MS, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PETER C KNUDSON DDS, MS, PC (OWNER)
(435) 723-6366
Entity
Organization

Contact information

Practice address
105 SKYLINE DR, BRIGHAM CITY, UT 84302-3108
(435) 723-6366
(435) 723-6371
Mailing address
105 SKYLINE DR, BRIGHAM CITY, UT 84302-3108
(435) 723-6366
(435) 723-6371

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
529449844016
UT
Enumeration date
07/01/2011
Last updated
07/01/2011
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