Individual
DR. DUSTIN PETRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8944 HAMILTON RD, PINE MOUNTAIN, GA 31822-4707
(706) 663-2272
Mailing address
102 MORGAN DR, LAGRANGE, GA 30240-6344
(706) 338-1828
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN015685
GA
Other
Enumeration date
06/13/2018
Last updated
06/13/2018
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