Individual
DR. DOUGLAS BRUCE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8470 US HWY 2, IRON RIVER, WI 54847-0400
(715) 372-4407
Mailing address
PO BOX 400, 8470 US HWY 2, IRON RIVER, WI 54847-0400
(715) 372-4407
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3879015
WI
Other
Enumeration date
09/14/2006
Last updated
07/08/2007
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