Individual
DR. SCOTT T PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D. M.S.
Contact information
Practice address
5235 W BASELINE RD, #187, LAVEEN, AZ 85339-3122
(602) 605-8811
Mailing address
4216 S MARIPOSA DR, GILBERT, AZ 85297-5224
(480) 440-6923
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D009577
AZ
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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