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Individual

DR. LORIN D. PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
101 HARRIS AVE, CLE ELUM, WA 98922-0580
(509) 674-5153
(509) 674-7354
Mailing address
101 HARRIS AVE, P.O. BOX 580, CLE ELUM, WA 98922-0580
(509) 674-5153
(509) 674-7354

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00005472
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5775002
WA
Enumeration date
05/02/2007
Last updated
07/08/2007
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