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Individual

MELISSA PETERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH, PHDHP

Contact information

Practice address
263 DWIGHTS RD, KANE, PA 16735-3713
(814) 366-3867
Mailing address
263 DWIGHTS RD, KANE, PA 16735-3713
(814) 366-3867

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
DH011007L
PA
124Q00000X
Dental Hygienist
Primary
PHDH000238
PA

Other

Enumeration date
01/02/2021
Last updated
01/02/2021
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