Individual
DR. COLLIN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
10409 BONEY AVE, DIBERVILLE, MS 39540-4813
(228) 809-8822
(228) 400-1240
Mailing address
10409 BONEY AVE, DIBERVILLE, MS 39540-4813
(228) 809-8822
(228) 400-1240
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4197-21
MS
Other
Enumeration date
06/08/2021
Last updated
02/12/2026
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