Kyle Pettersen, DDS

NPI #1275849986 in Lilburn, Georgia

Provider Information

NPI Number: 1275849986
Entity Type: Individual
Name: Kyle Pettersen, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Aug 19, 2010
Last Updated: Mar 26, 2021

Practice Location

Address: 609 BEAVER RUIN RD NW # A
City: Lilburn
State: Georgia
ZIP Code: 30047-3401
Phone: (678) 606-9407

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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