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Individual

DR. JORDAN PETERSCHMIDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
470 GLEN CREEK RD NW, SALEM, OR 97304-3060
(541) 905-3816
Mailing address
PO BOX 8021, SALEM, OR 97303-0224
(541) 905-3816

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10308
OR

Other

Enumeration date
08/05/2015
Last updated
08/05/2015
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