Organization
SCOTT T PETERSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT T PETERSON DMD (ORTHODONTIST)
(801) 710-2226
Entity
Organization
Contact information
Practice address
4216 S MARIPOSA DR, GILBERT, AZ 85297-5224
(801) 710-2226
Mailing address
25240 LAWTON AVE, LOMA LINDA, CA 92354-3541
(801) 710-2226
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D009577
AZ
Other
Enumeration date
08/24/2016
Last updated
08/24/2016
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