Individual
THOMAS P PETRICK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
157 GOOSE LANE, GUILFORD, CT 06437-2100
(203) 453-4475
(203) 453-3314
Mailing address
157 GOOSE LANE, GUILFORD, CT 06437-2100
(203) 453-4475
(203) 453-3314
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
CT007691
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007691
LICENSE NUMBER
CT
Enumeration date
09/20/2006
Last updated
03/07/2023
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