Individual
DR. DOUGLAS A PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9 MIDDLETOWN LINCROFT RD, LINCROFT, NJ 07738-1511
(732) 842-5005
(732) 842-8608
Mailing address
9 MIDDLETOWN LINCROFT RD, LINCROFT, NJ 07738-1511
(732) 842-5005
(732) 842-8608
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22D102109600
NJ
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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