Wayne Peterson Dmd Pc in Moscow - Dentist
Wayne Peterson Dmd Pc - NPI 1134389281
Wayne Peterson Dmd Pc is a Dentist in Moscow, Idaho. Wayne Peterson Dmd Pc practices all healthcare services and medical treatments related to Dentist. The NPI Number for Wayne Peterson Dmd Pc is 1134389281. The last update date is 2008-06-12.
Wayne Peterson Dmd Pc's current location address is 1138 West A St, Moscow, Idaho. You can contact this provider via phone number 2088829310 and fax number 2088828601. The mailing address for Wayne Peterson Dmd Pc is 1138 West A St, Moscow, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Wayne Peterson Dmd Pc |
|---|---|
| Address | 1138 West A St, Moscow, Idaho |
| Phone Number | 2088829310 |
| Fax Number | 2088828601 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Peterson Michael Wayne |
| Credentials | DMD |
| Telephone Number | 2088829310 |
NPI Number Detail
| NPI Number | 1134389281 |
|---|---|
| Provider Enumeration Date | 2008-06-12 |
| Last Updated Date | 2008-06-12 |
Provider Mailing Address Detail
| Address | 1138 West A St |
|---|---|
| City | Moscow |
| State | Idaho (ID) |
| Post Code | 83843 |
| Phone Number | 2088829310 |
| Fax Number | 2088828601 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | D1686 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the unique 10-digit identification code assigned to Wayne Peterson Dmd Pc by the Centers for Medicare & Medicaid Services?
The Wayne Peterson Dmd Pc has been issued the NPI (National Provider Identifier) 1134389281, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Wayne Peterson Dmd Pc located?
The Wayne Peterson Dmd Pc is located at 1138 West A St, Moscow, ID 83843.
What is the area of specialization for Wayne Peterson Dmd Pc, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Wayne Peterson Dmd Pc is Dentist, and the corresponding taxonomy code that categorizes this area of expertise is 122300000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1134389281 to Wayne Peterson Dmd Pc?
The Wayne Peterson Dmd Pc received its 1134389281 assignment from the Centers for Medicare & Medicaid Services on 2008-06-12.
As of what date were the details related to Wayne Peterson Dmd Pc most recently updated or revised?
The information pertaining to Wayne Peterson Dmd Pc, including its address, specialty, and other relevant details, was last updated or revised on 2008-06-12.
NPI Number: 1316940851
Address: 2410 N Glendale Dr Ste A, Fort Wayne, IN