Organization
VENN R. PETERSON, D.D.S., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VENN R PETERSON D.D.S. (DENTIST)
(360) 459-4420
Entity
Organization
Contact information
Practice address
5024 LACEY BLVD SE, LACEY, WA 98503-5729
(360) 459-4420
(360) 459-4425
Mailing address
5024 LACEY BLVD SE, LACEY, WA 98503-5729
(360) 459-4420
(360) 459-4425
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8985
WA
Other
Enumeration date
08/22/2007
Last updated
08/22/2007
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