TAYNE PETERSON

General Practice Dentistry

NPI: 1952960205Individual

Specialties, Licenses & Credentials

General Practice DentistryPrimary

Dentist — General Practice

Code: 1223G0001X

D-5401(ID)

Contact & Hours

Address: 2200 PARK AVE STE 2
BURLEY, ID 83318
Phone: (208) 878-6684

Quick Facts

NPI: 1952960205
Entity Type: Individual
Gender: Male
Medicare: Not confirmed
Specialties: 1
Locations: 1

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