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Individual

PETER KORN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RDHAP

Contact information

Practice address
11135 ROSEMARY DR, AUBURN, CA 95603-5945
(530) 906-7609
Mailing address
11135 ROSEMARY DR, AUBURN, CA 95603-5945
(530) 906-7609

Taxonomy

Speciality
Code
Description
License number
State
125K00000X
Advanced Practice Dental Therapist
Primary
757
CA

Other

Enumeration date
09/06/2019
Last updated
09/06/2019
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