| Venn R. Peterson, D.d.s., Inc. | |
|
5024 Lacey Blvd Se Lacey WA 98503-5729 | |
| (360) 459-4420 | |
| (360) 459-4425 |
| Full Name | Venn R. Peterson, D.d.s., Inc. |
|---|---|
| Speciality | Dentist |
| Location | 5024 Lacey Blvd Se, Lacey, Washington |
| Authorized Official Name and Position | Venn R Peterson (DENTIST) |
| Authorized Official Contact | 3604594420 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Venn R. Peterson, D.d.s., Inc. 5024 Lacey Blvd Se Lacey WA 98503-5729 Ph: (360) 459-4420 | Venn R. Peterson, D.d.s., Inc. 5024 Lacey Blvd Se Lacey WA 98503-5729 Ph: (360) 459-4420 |
| NPI Number | 1962695015 |
|---|---|
| Provider Enumeration Date | 08/22/2007 |
| Last Update Date | 08/22/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962695015 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 8985 (Washington) | Primary |
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