Individual
DR. PETER J. M. PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
625 HOPMEADOW ST., SIMSBURY, CT 06070
(860) 658-5552
(860) 651-8569
Mailing address
215 BALLARD DR,, WEST HARTFORD, CT 06119
(860) 233-1802
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
7255
CT
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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