GERALD D. PETERSEN D.D.S. S.C. NPI 1558464891

NPI Information

GERALD D. PETERSEN, D.D.S., S.C. is a general practice dentist in Waukesha, WI. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. GERALD D. PETERSEN, D.D.S., S.C. NPI is 1558464891. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

S22 W22660 EAST BROADWAY
STE 2B
WAUKESHA, WI
ZIP 53186
Phone: (262) 548-3555
Fax: (262) 965-2826

The provider's authorized official is Gerald D. Petersen .
The authorized official title is Officer and has the following contact phone number (262) 548-3555.

The enumeration date for this NPI number is 9/5/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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