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General NPI Number Information
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NPI Number | 1285051656
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Entity Type | Organization
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Legal Business Name | DANIEL PECK DDS INC PS
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Dates
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Enumeration Date | 03/24/2014
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Last Update Date | 10/08/2015
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Provider Practice Location Address
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Address Line | 20855 BOND RD NE
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City | POULSBO
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State | WA
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Zip | 98370-9014
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Country | US
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Telephone | 360-779-5546
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Fax | 360-697-4951
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Provider Business Mailing Address
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Address Line | 20855 BOND RD NE
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City | POULSBO
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State | WA
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Zip | 98370-9014
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Country | US
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Telephone | 360-779-5546
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Fax | 360-697-4951
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Authorized Official
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Title or Position | OWNER / PRESIDENT
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Name | DR. DANIEL G PECK
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Credential | DDS
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Telephone | 360-779-5546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 10941
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License Number State | WA
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