| Mark E Peterson, Dds | |
|
2440 Gaynor Ave Nw Grand Rapids MI 49544-1830 | |
| (616) 784-8444 | |
| (616) 784-6912 |
| Full Name | Mark E Peterson, Dds |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2440 Gaynor Ave Nw, Grand Rapids, Michigan |
| Authorized Official Name and Position | Mark Peterson (DENTIST) |
| Authorized Official Contact | 6167848444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark E Peterson, Dds 2440 Gaynor Ave Nw Grand Rapids MI 49544-1830 Ph: (616) 784-8444 | Mark E Peterson, Dds 2440 Gaynor Ave Nw Grand Rapids MI 49544-1830 Ph: (616) 784-8444 |
| NPI Number | 1639638265 |
|---|---|
| Provider Enumeration Date | 03/13/2019 |
| Last Update Date | 03/14/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639638265 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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