Michael Peterson, DDS

NPI 1942472691 · on the registry since 2008 · sole proprietor

Practice

Address: 5355 W State St
Boise, ID 83703
Phone: (208) 853-4687
Organisation at this address: White Smiles Llc
Lake Harbor Dental
Lake Harbor Dental Pllc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: Dentist
122300000X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2008-04-01

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