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Individual

DR. CARL FREDERICK PETERSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1200 MCFARLAND AVE, ROSSVILLE, GA 30741-2312
(706) 861-1828
(706) 861-1936
Mailing address
1200 MCFARLAND AVE, ROSSVILLE, GA 30741-2312
(706) 861-1828
(706) 861-1936

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS 8378
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000061685A
GA
Enumeration date
12/15/2006
Last updated
07/08/2007
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