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Tayne Peterson
NPI 1952960205 · on the registry since 2019
Practice
- Address
- 2200 Park Ave Ste 2
Burley, ID 83318 - Phone
- (208) 878-6684
- Fax
- (208) 678-3170
- Organisation at this address
- Stock & Garn Llp
Tayne A Peterson Dmd PllcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 4
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
- 2022-09-07
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