| David E. Petersen DDS | |
|
1025 E 11400 S 102 Sandy UT 84094-6942 | |
| (801) 576-8696 | |
| (801) 576-8466 |
| Full Name | David E. Petersen DDS |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1025 E 11400 S, Sandy, Utah |
| Authorized Official Name and Position | Corie Ann Schultz (SENIOR MANAGEMENT) |
| Authorized Official Contact | 8015735572 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David E. Petersen DDS 1025 E 11400 S 102 Sandy UT 84094-6942 Ph: (801) 576-8696 | David E. Petersen DDS 1025 E 11400 S 102 Sandy UT 84094-6942 Ph: (801) 576-8696 |
| NPI Number | 1659582237 |
|---|---|
| Provider Enumeration Date | 05/24/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659582237 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
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