Individual
MISS HANNAH B PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
3140 CLEARWATER DR, PRESCOTT, AZ 86305-7131
(928) 445-5959
Mailing address
8515 E LEIGH DR, #3, PRESCOTT VALLEY, AZ 86314-8162
(610) 909-7235
(610) 909-7235
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
6659
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
179557
ACCCHS PROVIDER
AZ
Enumeration date
11/06/2009
Last updated
11/06/2009
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