Individual
MARIE ANN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
8915 S 700 E STE 103, SANDY, UT 84070-2421
(015) 622-1478
Mailing address
8915 S 700 E STE 103, SANDY, UT 84070-2421
(801) 581-2121
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1811480239
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/11/2018
Last updated
11/20/2023
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