| Andrew M Petersen, Dds, Llc | |
|
4802 E Ray Rd Suite #19 Phoenix AZ 85044-6405 | |
| (480) 893-7733 | |
| Not Available |
| Full Name | Andrew M Petersen, Dds, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4802 E Ray Rd, Phoenix, Arizona |
| Authorized Official Name and Position | Andrew Marvin Petersen (OWNER) |
| Authorized Official Contact | 4808937733 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Andrew M Petersen, Dds, Llc 4802 E Ray Rd Suite #19 Phoenix AZ 85044-6405 Ph: (480) 893-7733 | Andrew M Petersen, Dds, Llc 4802 E Ray Rd Suite #19 Phoenix AZ 85044-6405 Ph: (480) 893-7733 |
| NPI Number | 1114189883 |
|---|---|
| Provider Enumeration Date | 06/25/2008 |
| Last Update Date | 06/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114189883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7013 (Arizona) | Primary |
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