Tyson Petersen, D.D.S

NPI 1457806457 · on the registry since 2016

Practice

Address: 1260 N 200 E
Logan, UT 84341
Phone: (435) 752-8000
Organisation at this address: Synergy Soft Tissue
Travis S. Baldwin, Dds, Pc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 5

Registry record

Primary taxonomy: 1223G0001X
1223G0001X
Also registered as: 1223G0001X
Licence states on file: ID, UT
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2022-07-21

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 Utah