Healthcare Provider Details

I. General information

NPI: 1285819243
Provider Name (Legal Business Name): OVE ANDREAS PETERS DMD MS PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 10/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 5TH ST
SAN FRANCISCO CA
94103-2919
US

IV. Provider business mailing address

239 CALIFORNIA AVE
MILL VALLEY CA
94941-3553
US

V. Phone/Fax

Practice location:
  • Phone: 415-351-7117
  • Fax:
Mailing address:
  • Phone: 415-383-7378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number56127
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: