Dr Tyson Peteresn
Dr Tyson Peteresn is a Dental Clinic/Center in Logan, Utah. Registered with an NPI since 2020.
- In the registry since
- 2020
Practice location Address checks out
110 E 200 NLogan, UT 84321-4007
Phone: (435) 752-0300
Fax: (435) 755-7625
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dental Clinic/Center (primary) | Taxonomy 261QD0000X |
|---|
Record details
| NPI number | 1972121770 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Tyson Petersen — Dr · (435) 752-0300 |
| NPI enumerated | July 8, 2020 |
| Last updated in NPPES | July 8, 2020 |
| Certification date | July 8, 2020 |
| Mailing address | 110 E 200 N, Logan, UT 84321-4007 |
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