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

Tayne Peterson

Individual provider General Practice Dentistry · NPI 1952960205

Tayne Peterson is a General Practice Dentistry in Burley, Idaho. Licensed in Idaho. Registered with an NPI since 2019.

Licensed in
ID
In the registry since
2019

Practice location Address checks out

2200 Park Ave Ste 2
Burley, ID 83318-2186
Phone: (208) 878-6684
Fax: (208) 678-3170
Show map & directions

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

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence D-5401 (ID)

Record details

NPI number1952960205
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 11, 2019
Last updated in NPPESSeptember 7, 2022
Certification dateSeptember 7, 2022
Mailing address2200 Park Ave, Burley, ID 83318-2186

Other providers in Burley