Individual
DANIELLE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
880 HERRIOT DR, MAUSTON, WI 53948-2031
(608) 847-6700
(608) 847-6122
Mailing address
PO BOX 1440, WAUTOMA, WI 54982-1440
(920) 787-5514
(920) 787-4737
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1001742-15
WI
Other
Enumeration date
01/22/2018
Last updated
01/22/2018
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