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General NPI Number Information
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NPI Number | 1154559813
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Entity Type | Organization
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Legal Business Name | PETERS & PETERS DDS
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Dates
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Enumeration Date | 07/01/2009
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Last Update Date | 02/22/2012
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Provider Practice Location Address
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Address Line | 6180 CLAY ST
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City | RIVERSIDE
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State | CA
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Zip | 92509-6047
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Country | US
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Telephone | 951-685-3355
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Fax | 951-685-0241
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Provider Business Mailing Address
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Address Line | 6180 CLAY ST
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City | RIVERSIDE
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State | CA
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Zip | 92509-6047
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Country | US
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Telephone | 951-685-3355
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. CARIE BIGGS
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Credential |
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Telephone | 951-685-3355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 23945
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License Number State | CA
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