Individual
DR. SHON J PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
11265 DECATUR ST STE 400, WESTMINSTER, CO 80234-4793
(303) 452-4656
(303) 254-6994
Mailing address
11265 DECATUR ST STE 400, WESTMINSTER, CO 80234-4793
(303) 452-4656
(303) 254-6994
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
8741
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699048439
—
CO
Enumeration date
09/06/2006
Last updated
04/15/2014
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