| Tayne Peterson, | |
|
2200 Park Ave Ste 2, Burley, ID 83318-2186 | |
| (208) 878-6684 | |
| (208) 678-3170 |
| Full Name | Tayne Peterson |
|---|---|
| Gender | Male |
| Speciality | Dentist - General Practice |
| Location | 2200 Park Ave Ste 2, Burley, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952960205 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D-5401 (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Tayne Peterson, 2200 Park Ave, Burley, ID 83318-2186 Ph: (208) 878-6684 | Tayne Peterson, 2200 Park Ave Ste 2, Burley, ID 83318-2186 Ph: (208) 878-6684 |
Dr. Michael Bryson Stucki, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1706 Overland Ave, Burley, ID 83318 Phone: 208-678-2332 | |
Dr. Kevin D. Banner, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 1010 E Main St, Burley, ID 83318 Phone: 208-678-5597 Fax: 208-678-5663 | |
Randal Todd Wilson, DMD Dentist Medicare: Medicare Enrolled Practice Location: 1309 Bennett Ave, Burley, ID 83318 Phone: 208-677-5198 | |
Dr. Steve Paul Garn, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 2200 Park Ave, Suite 2, Burley, ID 83318 Phone: 208-678-8188 Fax: 208-678-3170 | |
Wayne Jack Wright, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 2200 Park Ave, Burley, ID 83318 Phone: 208-678-1478 | |
Logan Kay, DMD Dentist Medicare: Medicare Enrolled Practice Location: 1309 Bennett Ave, Burley, ID 83318 Phone: 208-732-7447 | |
Dr. Justin Ward, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 2271 Overland Ave, Suite 4, Burley, ID 83318 Phone: 208-678-3265 |