Organization
PETERSON DENTISTRY DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY PETERSON DDS (OWNER)
(714) 672-9000
Entity
Organization
Contact information
Practice address
503 E IMPERIAL HWY, BREA, CA 92821-5544
(714) 672-9000
(714) 672-9086
Mailing address
503 E IMPERIAL HWY, BREA, CA 92821-5544
(714) 672-9000
(714) 672-9086
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
57102
CA
Other
Enumeration date
05/30/2018
Last updated
05/30/2018
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