Individual
CHASE PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
605 S COOLIDGE ST, MOSES LAKE, WA 98837-1873
(509) 765-0674
Mailing address
23864 N 162ND LN, SURPRISE, AZ 85387-1735
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DENT.DE.70139556
WA
Other
Enumeration date
07/28/2026
Last updated
07/28/2026
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