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Mark Peterson, DDS
NPI 1689782864 · on the registry since 2006 · sole proprietor
Practice
- Address
- 127 1/2 E Short St
Rigby, ID 83442 - Phone
- (208) 745-6536
- Fax
- (208) 745-0006
- Organisation at this address
- Mark L. Peterson
Rigby Dental, Inc.Inferred from a shared address, not stated in the registry.
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
- 2007-07-09
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