Organization
MARK L. PETERSON
Active
Other names
Peterson Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK L PETERSON DDS (DENTIST)
(208) 745-6536
Entity
Organization
Contact information
Practice address
127 1/2 E SHORT ST, RIGBY, ID 83442-1422
(208) 745-6536
(208) 745-0006
Mailing address
127 1/2 E SHORT ST, RIGBY, ID 83442-1422
(208) 745-6536
(208) 745-0006
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D1758
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001264500
—
ID
01
—
181636
IDAHO SMILES
—
01
—
476086
UNITED CONCORDIA
—
Enumeration date
06/03/2008
Last updated
06/03/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us