OrganizationActive
J. Dayne Petersen M.D., PC
NPI 1346597507 · Medical Specialty Clinic/Center · Salt Lake City, UT
Provider details
- NPI number
- 1346597507
- Entity type
- Organization
- Primary specialty
- Medical Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jason Petersen, President(801) 971-8684
- License
- 83185641205 (UT)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
5353 S 960 E
#150
Salt Lake City, UT 84117-3569
Phone: (801) 261-5791
Fax: (801) 747-7740
Approximate (ZIP-level) locationGet directions
Mailing address
5353 S 960 E
Salt Lake City, UT 84117-3569
Other names (DBA / former)
- Doing business as
- Nuvista Plastic Surgery
Registry dates
- Enumerated
- 2012-08-07
- Last updated
- 2012-08-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.