Individual
KAILA D PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6380 SPLIT ROCK AVE, TWENTYNINE PALMS, CA 92277-2550
(760) 365-9305
Mailing address
4750 ROUND UP RD, TWENTYNINE PALMS, CA 92277-6712
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
26680
CA
Other
Enumeration date
03/26/2026
Last updated
03/26/2026
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