Organization
SCOTT PETERSON DMD MS PLLC
Active
Other names
Peterson Family Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT PETERSON DMD MS (OWNER)
(480) 440-6923
Entity
Organization
Contact information
Practice address
35 W COMBS RD STE 102, QUEEN CREEK, AZ 85140-9102
(480) 725-9272
Mailing address
40615 N GANTZEL RD STE 107, SAN TAN VALLEY, AZ 85140-7010
(480) 725-9272
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D009577
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912452558
—
AZ
Enumeration date
08/18/2017
Last updated
08/13/2018
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