Douglas E Peterson DMD

NPI 1003813445 - Dentist - 1223G0001X

NPI Details
NPI 1003813445
Gender Male
Enumeration Date 06/30/2005
Last Updated 08/14/2013
Entity Type Individual
Active Over 11 years ago
Practice Location
263 FARMINGTON AVE
FARMINGTON CT, 06030-0001, US
Phone (860) 679-2952
Fax (860) 679-4760
Business Location
263 FARMINGTON AVE
PROVIDER ENROLLMENT
FARMINGTON CT, 06030-2212, US
Phone (860) 679-7503
Fax (860) 679-1610
Toxanomy
Taxonomy Code 1223G0001X
License State Connecticut
License Number 007480
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According to our database, Douglas E Peterson DMD NPI is 1003813445, taxonomy code is 1223G0001X and license number is 007480, license state is located at Connecticut. Douglas E Peterson DMD physically located at 263 Farmington Ave, Farmington CT, 06030-0001. NPI Number Douglas E Peterson DMD has the Individual type.

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1003813445 NPI number is provided on an as is basis without warranty of any kind. 1003813445 is maintained by the National Plan & Provider Enumeration System. The contents of Douglas E Peterson DMD are for informational purposes only.