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General NPI Number Information
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NPI Number | 1770871006
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Entity Type | Individual
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Provider Name | JAIME LYNNE PETERSON DDS
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Gender | Female
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Dates
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Enumeration Date | 07/20/2011
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Last Update Date | 09/01/2015
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Provider Practice Location Address
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Address Line | 38 ORANGE ST
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City | ASHEVILLE
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State | NC
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Zip | 28801-2341
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Country | US
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Telephone | 828-252-9351
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Fax |
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Provider Business Mailing Address
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Address Line | 120 FAIRWINDS DR
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City | HENDERSONVILLE
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State | NC
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Zip | 28791-4511
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Country | US
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Telephone | 412-897-9692
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 9182
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License Number State | NC
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