Individual
MRS. HEIDSHA L PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
927 N 71 BUSINESS HWY, ANDERSON, MO 64831
(417) 845-2273
(417) 845-8314
Mailing address
PO BOX 758, 475 NELSON AVE, NEOSHO, MO 64850
(417) 451-0619
(417) 451-8903
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2010031334
MO
Other
Enumeration date
12/05/2014
Last updated
12/05/2014
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