| Dr. Tyson Peteresn | |
|
110 E 200 N Logan UT 84321-4007 | |
| (435) 752-0300 | |
| (435) 755-7625 |
| Full Name | Dr. Tyson Peteresn |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 110 E 200 N, Logan, Utah |
| Authorized Official Name and Position | Tyson Petersen (DR) |
| Authorized Official Contact | 4357520300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Tyson Peteresn 110 E 200 N Logan UT 84321-4007 Ph: (435) 752-0300 | Dr. Tyson Peteresn 110 E 200 N Logan UT 84321-4007 Ph: (435) 752-0300 |
| NPI Number | 1972121770 |
|---|---|
| Provider Enumeration Date | 07/08/2020 |
| Last Update Date | 07/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972121770 | NPI | - | NPPES |
| PE1 | Other | UT | DENTAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Raymond Scott Hlavaty Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 E 200 No, Ste A, Logan, UT 84321 Phone: 435-753-2828 Fax: 435-753-3628 | |
Cache Valley Oral & Facial Surgery, Inc. Dental Clinic Medicare: Medicare Enrolled Practice Location: 1320 N 600 E, Suite 3, Logan, UT 84341 Phone: 435-752-5681 Fax: 435-752-5744 | |
Dr. Gary Foster Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 E 200 N, Logan, UT 84321 Phone: 435-752-0300 | |
Sterling Endodontics Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 E 200 N Ste G, Logan, UT 84321 Phone: 435-753-7668 | |
Larry T Hogge Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1230 N 200 E, Logan, UT 84341 Phone: 435-752-4134 Fax: 435-752-1020 | |
M. Andrew Johnson D.d.s. Lc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1153 N Main St, Suite B-150, Logan, UT 84341 Phone: 435-752-2153 | |
Thomson Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1445 N 400 E Ste 3, Logan, UT 84341 Phone: 435-752-1320 Fax: 435-750-6432 |