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Jason Peterson, DDS
NPI 1225255748 · on the registry since 2007 · sole proprietor
Practice
- Address
- 1980 1st St
Idaho Falls, ID 83401 - Phone
- (208) 524-3400
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- Periodontics
1223P0300X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-08
- Status
- Not present in the most recent federal file
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho