Nicholas Dee Petersen, DDS Valid NPI
Individual provider · General Practice Dentistry · Provo, UT
- NPI
- 1912790965
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 14223904-9926 (UT)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2025-05-23
- Last updated
- 2025-05-23
Practice location
1234 N 900 E Ste 100
Provo, UT 84604-2726
(801) 854-9140