Individual
CANDACE L PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
18795 SW BOONES FERRY RD, TUALATIN, OR 97062-8412
(503) 691-9046
(503) 692-7229
Mailing address
18795 SW BOONES FERRY RD, TUALATIN, OR 97062-6807
(503) 691-9046
(503) 692-7229
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6101
OR
Other
Enumeration date
07/13/2005
Last updated
03/04/2015
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