| Scott S Peters Dds Professional Corporation | |
|
1925 W Vista Way Vista CA 92083-6020 | |
| (559) 226-5000 | |
| (559) 227-4457 |
| Full Name | Scott S Peters Dds Professional Corporation |
|---|---|
| Speciality | Dentist |
| Location | 1925 W Vista Way, Vista, California |
| Authorized Official Name and Position | Scott Stuart Peters (PRESIDENT) |
| Authorized Official Contact | 5592265000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scott S Peters Dds Professional Corporation 3796 N Fresno St Ste 106 Fresno CA 93726-5500 Ph: (559) 226-5000 | Scott S Peters Dds Professional Corporation 1925 W Vista Way Vista CA 92083-6020 Ph: (559) 226-5000 |
| NPI Number | 1841308947 |
|---|---|
| Provider Enumeration Date | 08/28/2006 |
| Last Update Date | 04/08/2020 |
| Medicare PECOS PAC ID | 9436483062 |
|---|---|
| Medicare Enrollment ID | O20190701002220 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841308947 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 33353 (California) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
| Provider Name | Scott S Peters |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1902824279 PECOS PAC ID: 3971887589 Enrollment ID: I20190904000314 |
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