TY PETERSON, DMD

Dentist - General Practice

Active Individual
NPI: 1689234437

Practice Address

325 MAIN ST
Gooding, ID 83330

Phone: (208) 934-8080

Specialties

Specialty Code Primary License
Dentist - General Practice 1223G0001X Yes D-5035 (ID)

Frequently Asked Questions

NPI 1689234437 is the National Provider Identifier for TY PETERSON, DMD, a Dentist - General Practice provider located in Gooding, ID. This NPI was enumerated on June 14, 2019.
TY PETERSON, DMD practices at 325 MAIN ST, Gooding, ID 83330.

Quick Facts

NPI
1689234437
Type
Individual
Enumerated
Jun 14, 2019
Last Updated
Jun 14, 2019

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