Organization
PETERSON ORTHODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LANDON R PETERSON DDS, MS (OWNER)
(402) 330-9564
Entity
Organization
Contact information
Practice address
624 N 129TH ST STE 100, OMAHA, NE 68154-6110
(402) 330-9564
(402) 330-9564
Mailing address
624 N 129TH ST STE 100, OMAHA, NE 68154-6110
(402) 330-9564
(402) 330-9564
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10029018000
—
NE
Enumeration date
05/14/2025
Last updated
05/14/2025
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