Organization · Type 2 NPI
Tayne A Peterson DMD PLLC
Dental Clinic/Center · Burley, ID
NPI number
1942936406
Active
Practice location
2200 Park Ave Ste 2
Burley, ID 83318-2186
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
Another provider at this address
Other dental clinic/center providers in Burley
About NPI 1942936406
Tayne A Peterson DMD PLLC's National Provider Identifier is 1942936406, issued on Jul 27, 2022. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Burley, ID. The record was last updated on Sep 7, 2022.