Provider Demographics
NPI:1093715393
Name:PETERS, SKIFF EUGENE (DDS)
Entity Type:Individual
Prefix:
First Name:SKIFF
Middle Name:EUGENE
Last Name:PETERS
Suffix:
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 1:25127 S CENTER ST
Mailing Address - Street 2:
Mailing Address - City:LOS MOLINOS
Mailing Address - State:CA
Mailing Address - Zip Code:96055-9783
Mailing Address - Country:US
Mailing Address - Phone:530-576-3100
Mailing Address - Fax:305-763-1015
Practice Address - Street 1:25127 S CENTER ST
Practice Address - Street 2:
Practice Address - City:LOS MOLINOS
Practice Address - State:CA
Practice Address - Zip Code:96055-9783
Practice Address - Country:US
Practice Address - Phone:530-576-3100
Practice Address - Fax:530-576-3101
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA244961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice