Individual
DR. AUGUSTUS ALLEN PETTICOLAS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1342 PARK AVE, LYNCHBURG, VA 24501-1824
(434) 528-3375
(434) 528-2293
Mailing address
1342 PARK AVE, LYNCHBURG, VA 24501-1824
(434) 528-3375
(434) 528-2293
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
04977
VA
Other
Enumeration date
12/09/2006
Last updated
07/09/2007
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