Organization
PETERSON AND ABE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON PETERSON D.D.S. (PERIODONTIST)
(619) 298-2322
Entity
Organization
Contact information
Practice address
4076 3RD AVE, SUITE 201, SAN DIEGO, CA 92103-2129
(619) 292-2322
(619) 298-0679
Mailing address
4076 3RD AVE, SUITE 201, SAN DIEGO, CA 92103-2129
(619) 292-2322
(619) 298-0679
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
10/15/2014
Last updated
10/15/2014
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