Organization
PETERSON AND CAMMACK, D.D.S., P.L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VENN ROGER PETERSON D.D.S. (PRESIDENT)
(360) 459-4420
Entity
Organization
Contact information
Practice address
5201 CORPORATE CENTER CT SE, LACEY, WA 98503-5901
(360) 459-4420
(360) 459-4425
Mailing address
5201 CORPORATE CENTER CT SE, LACEY, WA 98503-5901
(360) 459-4420
(360) 459-4425
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00008985
WA
Other
Enumeration date
12/07/2012
Last updated
12/07/2012
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