Provider Demographics
NPI:1992704647
Name:PETERS, RIMA H (DMD)
Entity type:Individual
Prefix:DR
First Name:RIMA
Middle Name:H
Last Name:PETERS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8675 S PRIEST DR
Mailing Address - Street 2:STE 101
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-1914
Mailing Address - Country:US
Mailing Address - Phone:480-961-0600
Mailing Address - Fax:480-452-0348
Practice Address - Street 1:8675 S PRIEST DR
Practice Address - Street 2:STE.101
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-1914
Practice Address - Country:US
Practice Address - Phone:480-961-0600
Practice Address - Fax:480-452-0348
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6169122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ6169OtherDENTAL LICENSE