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Gary John Peterson, DDS
General Practice Dentistry in Antigo, Wisconsin
NPI 1538289467

Gary John Peterson is a General Practice Dentistry based in Deerbrook, WI and is specialized in General Practice. Gary John Peterson practices in Antigo, WI and has the professional credentials of DDS. The NPI Number for Gary John Peterson is 1538289467 and holds a License No. 2494 (Wisconsin).

The current practice location address for Gary John Peterson is 2010 Progress Blvd, Antigo, WI and can be reached out via phone at 715-623-7221.

Location: 2010 Progress Blvd, Antigo, WI, 54424-9246
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1538289467
Provider Name
Gary John Peterson
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
2010 Progress Blvd, Antigo, WI, 54424-9246
Phone Number
715-623-7221
Fax Number
Provider Enumeration Date
04/02/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
33407500 05 WI
institution
Provider Business Practice Location Address Details
Address
2010 Progress Blvd
City
Antigo
State
Wisconsin
Zip
54409-2475
Phone Number
715-623-7221
Fax Number
person
Provider Business Mailing Address Details
Address
2010 Progress Blvd
City
Antigo
State
Wisconsin
Zip
54409-2475
Phone Number
715-623-7221
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
2494 (Wisconsin)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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