Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mark E Peterson, DDS

Organization General Practice Dentistry · NPI 1639638265

Mark E Peterson, DDS is a General Practice Dentistry in Grand Rapids, Michigan. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

2440 Gaynor Ave NW
Grand Rapids, MI 49544-1830
Phone: (616) 784-8444
Fax: (616) 784-6912
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1639638265
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Peterson — Dentist · (616) 784-8444
NPI enumeratedMarch 13, 2019
Last updated in NPPESMarch 14, 2019
Mailing address2440 Gaynor Ave Nw, Grand Rapids, MI 49544-1830

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