Gus Charles Petras Dds in Redding - Pediatric Dentistry
Gus Charles Petras Dds - NPI 1790853653
Gus Charles Petras Dds is a Pediatric Dentistry in Redding, California. Gus Charles Petras Dds practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Gus Charles Petras Dds is 1790853653. The last update date is 2020-08-22.
Gus Charles Petras Dds's current location address is 400 Hartnell Avenue, Redding, California. You can contact this provider via phone number 5302222473 and fax number 5302223718. The mailing address for Gus Charles Petras Dds is 400 Hartnell Avenue, Redding, California. To know further, please read the information below!
Provider Profile Detail
Provider Organization | Gus Charles Petras Dds |
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Address | 400 Hartnell Avenue, Redding, California |
Phone Number | 5302222473 |
Fax Number | 5302223718 |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | DENTIST |
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Authorized Official Name | Petras Charles Gus |
Credentials | DDS |
Telephone Number | 5302222473 |
NPI Number Detail
NPI Number | 1790853653 |
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Provider Enumeration Date | 2006-11-30 |
Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
Address | 400 Hartnell Avenue |
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City | Redding |
State | California (CA) |
Post Code | 960021848 |
Phone Number | 5302222473 |
Fax Number | 5302223718 |
Provider's Primary Taxonomy Detail
Speciality | Pediatric Dentistry |
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Taxonomy | 1223P0221X |
Licence No | 22171 |
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
B2217101 | CA | MEDICAL DENTICAL |
Post Comment/ Review Below
What is the unique identifier code issued to Gus Charles Petras Dds by the Centers for Medicare & Medicaid Services (CMS)?
The Gus Charles Petras Dds has been assigned the NPI (National Provider Identifier) 1790853653. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you share the physical location details of Gus Charles Petras Dds?
The Gus Charles Petras Dds is situated at 400 Hartnell Avenue, in the city of Redding, state of CA, with the zip code 960021848.
What is Gus Charles Petras Dds's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Gus Charles Petras Dds is Pediatric Dentistry, and the taxonomy code that classifies this field of practice is 1223P0221X.
When was the Gus Charles Petras Dds's 1790853653 issued?
The Gus Charles Petras Dds's 1790853653 was issued on 2006-11-30.
As of what date was the information regarding Gus Charles Petras Dds, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Gus Charles Petras Dds, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2020-08-22.