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Justin Peterson, D.D.S
NPI 1386955029 · on the registry since 2010
Practice
- Address
- 325 E Main St
Saint Anthony, ID 83445 - Phone
- (208) 356-4900
- Fax
- (208) 624-4117
- Organisation at this address
- Upper Valley Community Health Services Inc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 3
Additional practice sites
- 72 S 1st E, Rexburg, ID
Registry record
- Primary taxonomy
- General Practice Dentistry
1223G0001X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-05-17
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