Provider Demographics
NPI:1215151907
Name:DESCHENES, PETER JOSEPH JR (DDS)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:JOSEPH
Last Name:DESCHENES
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 WASHINGTON VALLEY ROAD SUITE 102
Mailing Address - Street 2:PO BOX 4301
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-0301
Mailing Address - Country:US
Mailing Address - Phone:732-271-1818
Mailing Address - Fax:732-271-0207
Practice Address - Street 1:163 WASHINGTON VALLEY RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-7180
Practice Address - Country:US
Practice Address - Phone:732-271-1818
Practice Address - Fax:732-271-0207
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01281200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist