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Tayne A Peterson Dmd Pllc
Dental Clinic/Center in Burley, Idaho
NPI 1942936406

Tayne A Peterson Dmd Pllc is a Dental Clinic/Center based in Burley, ID and is specialized in Dental. Tayne A Peterson Dmd Pllc practices in Burley, ID. The NPI Number for Tayne A Peterson Dmd Pllc is 1942936406 and holds a License No. (Idaho).

The current practice location address for Tayne A Peterson Dmd Pllc is 2200 Park Ave Ste 2, Burley, ID and can be reached out via phone at 208-878-6684.

Location: 2200 Park Ave Ste 2, Burley, ID, 83318-2186
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1942936406
Provider Name
Tayne A Peterson Dmd Pllc
Credential
Provider Entity Type
Organization
Address
2200 Park Ave Ste 2, Burley, ID, 83318-2186
Phone Number
208-878-6684
Fax Number
Provider Enumeration Date
07/27/2022
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
2200 Park Ave Ste 2
City
Burley
State
Idaho
Zip
83318-2186
Phone Number
208-878-6684
Fax Number
person
Provider Business Mailing Address Details
Address
2200 Park Ave Ste 2
City
Burley
State
Idaho
Zip
83318-2186
Phone Number
208-878-6684
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
()
Definition
Definition to come...
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