Individual
DR. PATRICIA PECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DD1672
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009630
—
NM
01
—
1320507
UNITED CONCORDIA INS
NM
01
—
85-0477522
DELTA DENTAL INS
NM
Enumeration date
07/17/2006
Last updated
10/10/2013
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