Organization
FACIAL DIMENSIONS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
G A. PETERSON D.D.S., M.D. (PRESIDENT)
(308) 384-1172
Entity
Organization
Contact information
Practice address
710 W KOENIG ST, GRAND ISLAND, NE 68801-6556
(308) 384-1172
Mailing address
710 W KOENIG ST, GRAND ISLAND, NE 68801-6556
(308) 384-1172
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4372
NE
Other
Enumeration date
04/21/2009
Last updated
04/21/2009
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