| Ayleen R. Peterson Dds, Inc. | |
|
4221 Sunnyslope Ave Sherman Oaks CA 91423-3803 | |
| (310) 710-7854 | |
| Not Available |
| Full Name | Ayleen R. Peterson Dds, Inc. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 4221 Sunnyslope Ave, Sherman Oaks, California |
| Authorized Official Name and Position | Ayleen Peterson (PRESIDENT) |
| Authorized Official Contact | 3107107854 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ayleen R. Peterson Dds, Inc. 4221 Sunnyslope Ave Sherman Oaks CA 91423-3803 Ph: (310) 710-7854 | Ayleen R. Peterson Dds, Inc. 4221 Sunnyslope Ave Sherman Oaks CA 91423-3803 Ph: (310) 710-7854 |
| NPI Number | 1225509268 |
|---|---|
| Provider Enumeration Date | 12/17/2018 |
| Last Update Date | 12/12/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225509268 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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