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Individual

KAREN PETERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
600 RICHARDSON DR, BLD. # 634, FORT RICHARDSON, AK 99505-8310
(907) 384-2483
Mailing address
600 RICHARDSON DR, BLD. # 634, FORT RICHARDSON, AK 99505-8310
(907) 384-2483

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
413
AK
124Q00000X
Dental Hygienist
458
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
413
STATE OF AK DENTAL HYGIENE LICENSE
AK
01
458
STATE OF AK LOCAL ANESTHETIC LICENSE
AK
Enumeration date
06/13/2016
Last updated
06/13/2016
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