| Peterson Family Orthodontics | |
|
35 W Combs Rd Ste 102 Queen Creek AZ 85140-9102 | |
| (480) 725-9272 | |
| Not Available |
| Full Name | Peterson Family Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 35 W Combs Rd Ste 102, Queen Creek, Arizona |
| Authorized Official Name and Position | Scott Peterson (OWNER) |
| Authorized Official Contact | 4804406923 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peterson Family Orthodontics 40615 N Gantzel Rd Ste 107 San Tan Valley AZ 85140-7010 Ph: (480) 725-9272 | Peterson Family Orthodontics 35 W Combs Rd Ste 102 Queen Creek AZ 85140-9102 Ph: (480) 725-9272 |
| NPI Number | 1558887893 |
|---|---|
| Provider Enumeration Date | 08/18/2017 |
| Last Update Date | 08/13/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558887893 | NPI | - | NPPES |
| 1912452558 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | D009577 (Arizona) | Primary |
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