Individual
LESILIE A PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1905 E MCKELLIPS RD, MESA, AZ 85203-2865
(480) 649-1949
Mailing address
518 N DANYELL DR, CHANDLER, AZ 85225-8209
(480) 649-1949
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1952
AZ
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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