Organization
VANESSA PETERSON, DDS, MS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VANESSA PETERSON (OWNER)
(909) 774-0107
Entity
Organization
Contact information
Practice address
10165 FOOTHILL BLVD STE 2, RANCHO CUCAMONGA, CA 91730-0341
(909) 774-0107
(909) 774-0107
Mailing address
10165 FOOTHILL BLVD STE 2, RANCHO CUCAMONGA, CA 91730-0341
(097) 740-1079
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
01/29/2020
Last updated
04/24/2023
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