Provider Demographics
NPI:1164572657
Name:LAFRENIERE, PETER A (DDS)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:A
Last Name:LAFRENIERE
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 1:200 MARQUETTE ST
Mailing Address - Street 2:
Mailing Address - City:NEGAUNEE
Mailing Address - State:MI
Mailing Address - Zip Code:49866-1832
Mailing Address - Country:US
Mailing Address - Phone:906-475-9933
Mailing Address - Fax:
Practice Address - Street 1:200 MARQUETTE ST
Practice Address - Street 2:
Practice Address - City:NEGAUNEE
Practice Address - State:MI
Practice Address - Zip Code:49866-1832
Practice Address - Country:US
Practice Address - Phone:906-475-9933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI137711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice