Provider Demographics
NPI:1821169830
Name:WORTH, PETER W (DDS)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:W
Last Name:WORTH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9197 GREENBACK LANE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ORANGEVALE
Mailing Address - State:CA
Mailing Address - Zip Code:95662
Mailing Address - Country:US
Mailing Address - Phone:916-989-3300
Mailing Address - Fax:916-989-2187
Practice Address - Street 1:9197 GREENBACK LANE
Practice Address - Street 2:SUITE A
Practice Address - City:ORANGEVALE
Practice Address - State:CA
Practice Address - Zip Code:95662
Practice Address - Country:US
Practice Address - Phone:916-989-3300
Practice Address - Fax:916-989-2187
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA230661223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics