Organization
JON E PETERSON D.D.S. , APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON E PETERSON DDS (PRESIDENT)
(619) 298-2322
Entity
Organization
Contact information
Practice address
4076 3RD AVE STE 201, SAN DIEGO, CA 92103-2129
(619) 298-2322
Mailing address
4076 3RD AVE STE 201, SAN DIEGO, CA 92103-2129
(619) 298-2322
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
28790
CA
Other
Enumeration date
09/28/2006
Last updated
07/16/2013
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