Provider Demographics
NPI:1831086206
Name:PETERS, JOSEPH II (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:PETERS
Suffix:II
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 CAGES RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3620
Mailing Address - Country:US
Mailing Address - Phone:607-738-6649
Mailing Address - Fax:
Practice Address - Street 1:106 CUDE LN
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-2202
Practice Address - Country:US
Practice Address - Phone:615-865-1733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12823122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist