Individual provider · Type 1 NPI

Tayne Peterson

General Practice Dentistry · Burley, ID

NPI number 1952960205 Active

Practice location

2200 Park Ave Ste 2
Burley, ID 83318-2186

Call (208) 878-6684 Map

Fax (208) 678-3170

Mailing address

2200 Park Ave
Burley, ID 83318-2186

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001XD-5401 (ID)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

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About NPI 1952960205

Tayne Peterson's National Provider Identifier is 1952960205, issued on Jun 11, 2019. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Burley, ID. The record was last updated on Sep 7, 2022.