Organization
MOUNTAIN VALLEY DENTAL- PETERSEN, LLC
Active
Other names
David E. Petersen DDS
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CORIE ANN SCHULTZ (SENIOR MANAGEMENT)
(801) 573-5572
Entity
Organization
Contact information
Practice address
1025 E 11400 S, 102, SANDY, UT 84094-6942
(801) 576-8696
(801) 576-8466
Mailing address
1025 E 11400 S, 102, SANDY, UT 84094-6942
(801) 576-8696
(801) 576-8466
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/24/2007
Last updated
08/22/2020
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