Michelle Lynn Petersen D.D.S.

NPI 1063488047 - Dentist - 1223G0001X

NPI Details
NPI 1063488047
Gender Female
Enumeration Date 02/28/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
8010 STATE LINE RD
SUITE 210
PRAIRIE VILLAGE KS, 66208-3710, US
Phone (913) 341-2200
Fax (913) 648-7605
Business Location
8010 STATE LINE RD
SUITE 210
PRAIRIE VILLAGE KS, 66208-3710, US
Phone (913) 341-2200
Fax (913) 648-7605
Toxanomy
Taxonomy Code 1223G0001X
License State Kansas
License Number 5735
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According to our database, Dr. Michelle Lynn Petersen D.D.S. NPI is 1063488047, taxonomy code is 1223G0001X and license number is 5735, license state is located at Kansas. Michelle Lynn Petersen D.D.S. physically located at 8010 State Line Rd, Prairie Village KS, 66208-3710. NPI Number Michelle Lynn Petersen D.D.S. has the Individual type.

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1063488047 NPI number is provided on an as is basis without warranty of any kind. 1063488047 is maintained by the National Plan & Provider Enumeration System. The contents of Michelle Lynn Petersen D.D.S. are for informational purposes only.