| Katie D. Peterson, DDS, PC | |
|
920 N Main St Mountain Grove MO 65711-1315 | |
| (417) 926-4910 | |
| (417) 926-4399 |
| Full Name | Katie D. Peterson, DDS, PC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 920 N Main St, Mountain Grove, Missouri |
| Authorized Official Name and Position | Katie Dawn Peterson (PRESIDENT) |
| Authorized Official Contact | 4179264910 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Katie D. Peterson, DDS, PC 920 N Main St Mountain Grove MO 65711-1315 Ph: (417) 926-4910 | Katie D. Peterson, DDS, PC 920 N Main St Mountain Grove MO 65711-1315 Ph: (417) 926-4910 |
| NPI Number | 1326301359 |
|---|---|
| Provider Enumeration Date | 06/25/2012 |
| Last Update Date | 06/25/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326301359 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2012015429 (Missouri) | Primary |
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