Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KELSEY PETERSON, DMD
Active Sole ProprietorKELSEY PETERSON, DMD is a General Dentistry healthcare provider located in EMMETT, Idaho. NPI 1396069712 is currently active in the NPPES registry. Verify at CMS.
General Dentistry · EMMETT, ID
Registration Details
- NPI Number
- 1396069712
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 15, 2010 (16.399046864052 yrs)
- Last Updated
- Feb 13, 2024
- Licenses
-
D-4282-OR (ID)D-4282 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1312 SOUTH WASHINGTON STREETEMMETT, ID, 83617Browse ID providers · Browse ZIP 83617
- Phone
- 2089416640
- Primary Specialty
-
General Dentistry
1223G0001X
- Additional Specialty
- General Dentistry
Other General Dentistry Providers in EMMETT, ID
| Name | Credential | NPI |
|---|---|---|
| DR. SHON DEWANE ROOKS | D.D.S. | 1376592337 |
| DARREN K WALLACE | D.M.D. | 1841305646 |
| MRS. ANDREA L WALLACE | D.M.D. | 1871608604 |
| DR. WARREN RICHARD WILLIS | D.M.D | 1568535011 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.