Provider Demographics
NPI:1053576587
Name:CALDERON, PETER ORLANDO (DDS)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:ORLANDO
Last Name:CALDERON
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 1:6658 AIRPORT HWY
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-8135
Mailing Address - Country:US
Mailing Address - Phone:419-867-3400
Mailing Address - Fax:
Practice Address - Street 1:6658 AIRPORT HWY
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-8135
Practice Address - Country:US
Practice Address - Phone:419-867-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2022-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901019906122300000X
OH3023080122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist