Individual
DR. DUSTIN JAMES PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1625 RIO BRAVO BLVD SW, ALBUQUERQUE, NM 87105-6057
(505) 404-9381
Mailing address
1625 RIO BRAVO BLVD SW, ALBUQUERQUE, NM 87105-6057
(505) 404-9381
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD4752
NM
Other
Enumeration date
07/12/2017
Last updated
07/21/2022
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