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NPI Code Detail

MEDICARE: THOMAS ROBERT PETERS DDS

MEDICARE: THOMAS ROBERT PETERS DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistD10004OR
2122300000XDentistDE60267784WA

General Provider Information

NPI Number : 1053444026
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS ROBERT PETERS DDS
Provider Business Mailing Address
First Line : 6950 NE CAMPUS WAY
Second Line :
City : HILLSBORO
State : OR
Zip : 97124-5611
Country : US
Telephone Number : 503-952-2137
Fax Number :
Provider Business Practice Location Address
First Line : 6950 NE CAMPUS WAY
Second Line :
City : HILLSBORO
State : OR
Zip : 97124-5611
Country : US
Telephone Number : 503-952-2137
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2007
Last Update Date : 06/03/2015

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Directions to “ THOMAS ROBERT PETERS DDS” Practice Location

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