Doctor Name: | HANS C PETERSEN |
NPI Number: | 1255497079 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DMD |
License Number: | 5323980 |
Business Practice Address: | 216 East Main Street #c Lehi, UT - 840436634 |
Business Phone Number: | 8017665557 |
Business Fax Number: | 8017680541 |
Mailing Address: | 216 East Main Street, #c LEHI |
State: | UT |
Postal Code: | 840436634 |
Phone Number: | 8017665557 |
Fax Number: | 8017680541 |
NPI Enumeration Date: | 12/28/2006 |
NPI Last Update Date: | 05/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 5323980 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |