NPI 1013134931

Donald P Peterson, DDSFAGD

Practitioner General Practice Dentistry Waldorf, MD

Practice location

Address: 11855 Holly Ln Suite #103, Waldorf, MD 20601-3114
Phone: (301) 645-7585
Fax: (301) 843-3367

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 9177 (MD)

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Registry record

NPI: 1013134931
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Apr 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.