Individual
DR. LUKE R. PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3078 W 7800 S, WEST JORDAN, UT 84088-3707
(801) 280-1911
(801) 255-2394
Mailing address
1694 DEVONSHIRE DR, SALT LAKE CITY, UT 84108-2559
(801) 560-6284
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7702761-99021
UT
Other
Enumeration date
06/29/2010
Last updated
06/29/2010
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