Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TY PETERSON, DMD
Active Sole ProprietorTY PETERSON, DMD is a General Dentistry healthcare provider located in GOODING, Idaho. NPI 1689234437 is currently active in the NPPES registry. Verify at CMS.
General Dentistry · GOODING, ID
Registration Details
- NPI Number
- 1689234437
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 14, 2019 (7.1502068213344 yrs)
- Last Updated
- Jun 14, 2019
- License
-
D-5035 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
325 MAIN STGOODING, ID, 833301302Browse ID providers · Browse ZIP 83330
- Phone
- 2089348080
- Fax
- 2089349756
- Primary Specialty
-
General Dentistry
1223G0001X
Other General Dentistry Providers in GOODING, ID
| Name | Credential | NPI |
|---|---|---|
| DR. LAWRENCE JOHN CHILD | DDS, PC | 1811099765 |
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.