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Tayne Peterson
General Practice Dentistry in Burley, Idaho
NPI 1952960205

Tayne Peterson is a General Practice Dentistry based in Burley, ID and is specialized in General Practice. Tayne Peterson practices in Burley, ID. The NPI Number for Tayne Peterson is 1952960205 and holds a License No. D-5401 (Idaho).

The current practice location address for Tayne Peterson is 2200 Park Ave Ste 2, Burley, ID and can be reached out via phone at 208-878-6684 and via fax at 208-678-3170.

Location: 2200 Park Ave Ste 2, Burley, ID, 83318-2186
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1952960205
Provider Name
Tayne Peterson
Credential
Provider Entity Type
Individual
Gender
Male
Address
2200 Park Ave Ste 2, Burley, ID, 83318-2186
Phone Number
208-878-6684
Fax Number
208-678-3170
Provider Enumeration Date
06/11/2019
Last Update Date
03/10/2024
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
208-678-3170
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
208-678-3170
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
D-5401 (Idaho)
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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