David Shane Petrie in Fayetteville - Dentist
David Shane Petrie - NPI 1104957521
David Shane Petrie is a Dentist in Fayetteville, Georgia. David Shane Petrie practices all healthcare services and medical treatments related to Dentist. The NPI Number for David Shane Petrie is 1104957521. The last update date is 2007-07-08.
David Shane Petrie's current location address is 320 N Jeff Davis Dr Ste B, Fayetteville, Georgia. You can contact this provider via phone number 7704613921 and fax number 7704610944. The mailing address for David Shane Petrie is 320 N Jeff Davis Dr Ste B, Fayetteville, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | David Shane Petrie |
|---|---|
| Address | 320 N Jeff Davis Dr Ste B, Fayetteville, Georgia |
| Phone Number | 7704613921 |
| Fax Number | 7704610944 |
| Sole Proprietor | Y |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1104957521 |
|---|---|
| Provider Enumeration Date | 2007-03-08 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 320 N Jeff Davis Dr Ste B |
|---|---|
| City | Fayetteville |
| State | Georgia (GA) |
| Post Code | 302141669 |
| Phone Number | 7704613921 |
| Fax Number | 7704610944 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 8534 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Post Comment/ Review Below
What is the unique 10-digit identification code assigned to David Shane Petrie by the Centers for Medicare & Medicaid Services?
The David Shane Petrie has been issued the NPI (National Provider Identifier) 1104957521, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where David Shane Petrie's facilities are geographically located?
The facilities of David Shane Petrie are physically situated at the following location: 320 N Jeff Davis Dr Ste B, Fayetteville, GA, 302141669.
What is David Shane Petrie's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The David Shane Petrie's specialized field of practice is Dentist, and the corresponding taxonomy code that categorizes this area of specialization is 122300000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1104957521 to David Shane Petrie?
The David Shane Petrie received its 1104957521 assignment from the Centers for Medicare & Medicaid Services on 2007-03-08.
As of what date was the information regarding David Shane Petrie, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to David Shane Petrie, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.
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