Tayne Peterson
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 2Burley, ID 83318-2186
Phone: (208) 878-6684
Fax: (208) 678-3170
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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 · Licence D-5401 (ID) |
|---|
Record details
| NPI number | 1952960205 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | June 11, 2019 |
| Last updated in NPPES | September 7, 2022 |
| Certification date | September 7, 2022 |
| Mailing address | 2200 Park Ave, Burley, ID 83318-2186 |
Other providers in Burley
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Dr. Steve Paul Garn, DDS
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-
Dr. Val Garn, DDS
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Jared C Johnson, DDS
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Dr. Kelby James Olson, DMD
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Dr. Ronald C Rice, DDS
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Seasons Dental
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Stock & Garn LLP
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