DR. David Shane Petrie, DDS
NPI #1104957521 in Fayetteville, Georgia
Provider Information
- NPI Number
- 1104957521
- Entity Type
- Individual
- Name
- DR. David Shane Petrie, DDS
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist
- Credential
- DDS
- Enumeration Date
- Mar 8, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 320 N JEFF DAVIS DR STE B
- City
- Fayetteville
- State
- Georgia
- ZIP Code
- 30214-1669
- Phone
- (770) 461-3921
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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