Individual
KEVIN L PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1 BROOKLINE PL, SUITE 505, BROOKLINE, MA 02445-7224
(617) 735-8500
Mailing address
220 BOYLSTON ST, APT. 9018, BOSTON, MA 02116-3929
(617) 216-8042
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
19670
MA
Other
Enumeration date
07/28/2006
Last updated
07/08/2007
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