Hannah Jean Peterman, DMD

Individual provider Active NPI General Practice Dentistry · Wiggins, MS

NPI 1104550896 · NPPES record last updated Feb 13, 2024

Key facts

NPI
1104550896
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
4315-22 (MS)
Practice address
551 Frontage Dr E
Wiggins, MS 39577-8120
Phone
(601) 476-9007
NPI assigned
Jul 11, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4315-22MSMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4315-22 MS Yes

Addresses

Primary practice location

551 Frontage Dr E
Wiggins, MS 39577-8120

Mailing address

16170 McKay Rd
Gulfport, MS 39503-7000
Phone (662) 820-9001

Other providers in Wiggins, MS

All providers in Wiggins, MS · General Practice Dentistry in Mississippi

Sources for this page

Verify at the official NPI Registry.