Provider Demographics
NPI:1295769800
Name:CLAUSSEN, PETER B (DDS)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:B
Last Name:CLAUSSEN
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 1:2636 JENKS AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4387
Mailing Address - Country:US
Mailing Address - Phone:850-769-3597
Mailing Address - Fax:850-215-0698
Practice Address - Street 1:2636 JENKS AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4387
Practice Address - Country:US
Practice Address - Phone:850-769-3597
Practice Address - Fax:850-215-0698
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL71181223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry