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Individual
DR. JANNA LYNN PETTIGREW
Active
Individual
DR. JANNA LYNN PETTIGREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6034
OK
1223G0001X
General Practice Dentistry
3728
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200212860A
—
OK
Enumeration date
06/23/2008
Last updated
07/01/2016
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