person
Lillian Petersen, CDL,LD
Denturist in Florence, Oregon
NPI 1699198663

Lillian Petersen is a Denturist based in Florence, OR. Lillian Petersen practices in Florence, OR and has the professional credentials of CDL,LD. The NPI Number for Lillian Petersen is 1699198663 and holds a License No. DT DO 706283 (Oregon).

The current practice location address for Lillian Petersen is 524 Laurel Street, Florence, OR and can be reached out via phone at 541-997-6054 and via fax at 541-997-6054.

Location: 524 Laurel Street, Florence, OR, 97439-0004
person
Provider Profile Details
NPI Number
1699198663
Provider Name
Lillian Petersen
Credential
CDL,LD
Provider Entity Type
Individual
Gender
Female
Address
524 Laurel Street, Florence, OR, 97439-0004
Phone Number
541-997-6054
Fax Number
541-997-6054
Provider Enumeration Date
01/28/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
122400000X 01 OR DENTURIST
institution
Provider Business Practice Location Address Details
Address
524 Laurel Street
City
State
Zip
97439-0004
Phone Number
541-997-6054
Fax Number
541-997-6054
person
Provider Business Mailing Address Details
Address
524 Laurel Street
City
State
Zip
97439-0004
Phone Number
541-997-6054
Fax Number
541-997-6054
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Denturist
Speciality
-
Taxonomy
License No.
DT DO 706283 (Oregon)
Definition
Definition to come.
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