MEDICARE: ALAN L. PEET DDS PLLC

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
1	261QD0000X	Dental Clinic/Center	DE00007233	WA

General Provider Information

NPI Number	:	1437185006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALAN L. PEET DDS PLLC

Provider Business Mailing Address
First Line	:	550 N 5TH AVE
Second Line	:
City	:	SEQUIM
State	:	WA
Zip	:	98382-3079
Country	:	US
Telephone Number	:	360-681-0900
Fax Number	:	360-681-0875

Provider Business Practice Location Address
First Line	:	550 N 5TH AVE
Second Line	:
City	:	SEQUIM
State	:	WA
Zip	:	98382-3079
Country	:	US
Telephone Number	:	360-681-0900
Fax Number	:	360-681-0875

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALAN L PEET
Credential	:	DDS
Telephone Number	:	360-681-0900

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	12/10/2009

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