Organization
PETERSEN DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUKE PETERSEN DDS (OWNER)
(801) 302-8989
Entity
Organization
Contact information
Practice address
10458 S REDWOOD RD, SOUTH JORDAN, UT 84095-8501
(801) 302-8989
(801) 302-8989
Mailing address
10458 S REDWOOD RD, SOUTH JORDAN, UT 84095-8501
(801) 302-8989
(801) 302-8989
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7702761-99021
UT
Other
Enumeration date
02/02/2016
Last updated
02/02/2016
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