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General NPI Number Information
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NPI Number | 1780815217
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Entity Type | Individual
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Provider Name | KENNETH STEVEN PETERS D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/31/2009
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Last Update Date | 07/31/2009
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Provider Practice Location Address
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Address Line | 200 W COUNTY LINE RD SUITE 270
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80129-2360
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Country | US
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Telephone | 303-791-2570
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Fax | 303-683-4198
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Provider Business Mailing Address
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Address Line | 200 WEST COUNTY LINE RD SUITE 270
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80129-2342
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Country | US
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Telephone | 303-791-2570
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Fax | 303-683-4198
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 105737
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License Number State | CO
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