Bryan J. Petersen, D.D.S.
General Dentistry · Grangeville, ID
UnclaimedD.D.S.NPI 1205994373
- Primary taxonomy
- 122300000X
- Enumerated
- 2006-12-04
- Practice location
- Grangeville, ID
- Last NPPES update
- 2007-07-08
State licenses
- ID · Dentist · NPPES self-reportedListed on NPI record
“Listed on NPI record” means the provider reported this license to NPPES; other statuses come from the state board’s public records as of the last import. License numbers are not shown.
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.