Individual provider · Type 1 NPI
Samuel George Petersen, DDS
Oral and Maxillofacial Surgery (Dentist) · Sonora, CA
NPI number
1780848119
Active
Practice location
940 Sylva Ln Ste K1
Sonora, CA 95370-5969
Fax (209) 532-6216
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) Primary | 1223S0112X | 51511 (CA) |
Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Another provider at this address
Other oral and maxillofacial surgery (dentist) providers in Sonora
About NPI 1780848119
Samuel George Petersen, DDS's National Provider Identifier is 1780848119, issued on Jul 15, 2008. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Sonora, CA. The record was last updated on Jul 15, 2008.