Individual
DR. KIRK PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
22833 BOTHELL EVERETT HWY, SUITE 205, BOTHELL, WA 98021-9385
(425) 485-6540
Mailing address
20023 10TH AVE NW, SHORELINE, WA 98177-2110
(206) 963-3175
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5471
WA
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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