Individual provider · Type 1 NPI
Jason M. Peterson, DDS
Periodontics · Idaho Falls, ID
NPI number
1225255748
Active
Practice location
1980 1st St
Idaho Falls, ID 83401-4342
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Periodontics Primary | 1223P0300X | D3325PE (ID) |
Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
Another provider at this address
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About NPI 1225255748
Jason M. Peterson, DDS's National Provider Identifier is 1225255748, issued on Apr 18, 2007. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Idaho Falls, ID. The record was last updated on Jul 8, 2007.