NPI 1235179466
Wayne Michael Peterson, DMD
Practice location
- Address
- 1138 W a St, Moscow, ID 83843-2127
- Phone
- (208) 882-9310
- Fax
- (208) 882-8601
Registered specialties
General Practice Dentistry
Primary
Registry record
- NPI
- 1235179466
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 7 Jun 2006
- Record last updated
- 13 Jul 2026
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.