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Individual

DR. NOAH J PETERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
715 W CENTRAL AVE, MISSOULA, MT 59801-6808
(406) 728-2840
(406) 728-3083
Mailing address
715 W CENTRAL AVE, MISSOULA, MT 59801-6808
(406) 728-2840
(406) 728-3083

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2249
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0113305
MT
01
41244
BCBS
MT
01
5512754
CHIP
MT
Enumeration date
07/02/2007
Last updated
01/13/2011
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