Individual
DR. SAMUEL GEORGE PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
940 SYLVA LN STE K1, SONORA, CA 95370-5969
(209) 532-5578
(209) 532-6216
Mailing address
940 SYLVA LN STE K1, SONORA, CA 95370-5969
(209) 532-5578
(209) 532-6216
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
51511
CA
Other
Enumeration date
07/15/2008
Last updated
07/15/2008
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