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General NPI Number Information
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NPI Number | 1912016866
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Entity Type | Individual
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Provider Name | RICHARD C PETERS DDS
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 01/24/2014
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Provider Practice Location Address
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Address Line | 199 HWY 50
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City | PECOS
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State | NM
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Zip | 87552-0710
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Country | US
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Telephone | 505-757-6666
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Fax | 505-757-2700
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Provider Business Mailing Address
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Address Line | PO BOX 710 199HWY 50
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City | PECOS
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State | NM
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Zip | 87552-0710
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Country | US
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Telephone | 505-757-6666
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Fax | 505-757-2700
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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 | 1335
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License Number State | NM
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