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

Daniel Bryce Petersen, DMD

Individual provider Dentist · NPI 1003498825

Daniel Bryce Petersen, DMD is a Dentist in Shaw AFB, South Carolina. Licensed in South Carolina. Registered with an NPI since 2021.

Licensed in
SC
In the registry since
2021
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

See every abbreviation used in this directory →

Practice location Address checks out

420 Polifka Dr Bldg 1042
Shaw AFB, SC 29152-5100
Phone: (803) 895-6951
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 10414 (SC)

Record details

NPI number1003498825
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedApril 21, 2021
Last updated in NPPESNovember 25, 2024
Certification dateNovember 25, 2024
Mailing address420 Polifka Dr Bldg 1042, Shaw Afb, SC 29152-5100

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