Individual
DR. BURKE B. PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
250 E BROADWAY, SUITE 310, SALT LAKE CITY, UT 84111-2418
(801) 322-4082
(801) 322-4082
Mailing address
250 E BROADWAY, SUITE 310, SALT LAKE CITY, UT 84111-2418
(801) 322-4082
(801) 322-4082
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
135446
UT
1223G0001X
General Practice Dentistry
37895
UT
Other
Enumeration date
05/31/2007
Last updated
07/08/2007
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