| Eric L Peterson Dds Pc | |
|
225 Scottwood Ave Elmira Heights NY 14903-1322 | |
| (607) 733-3616 | |
| (607) 733-1053 |
| Full Name | Eric L Peterson Dds Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 225 Scottwood Ave, Elmira Heights, New York |
| Authorized Official Name and Position | Eric Laurence Peterson (PRESIDENT) |
| Authorized Official Contact | 6077333616 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eric L Peterson Dds Pc 225 Scottwood Ave Elmira Heights NY 14903-1322 Ph: (607) 733-3616 | Eric L Peterson Dds Pc 225 Scottwood Ave Elmira Heights NY 14903-1322 Ph: (607) 733-3616 |
| NPI Number | 1639165384 |
|---|---|
| Provider Enumeration Date | 09/27/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639165384 | NPI | - | NPPES |
| 02169271 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 049002 (New York) | Primary |