Individual
DR. HEATHER N. PETRICIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1101 S COLUMBIA RD STE B, GRAND FORKS, ND 58201-4055
(218) 230-4352
Mailing address
1101 S COLUMBIA RD STE B, GRAND FORKS, ND 58201-4055
(218) 230-4352
(701) 795-1102
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2083
ND
1223G0001X
General Practice Dentistry
6419
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41564
—
ND
Enumeration date
07/08/2009
Last updated
03/10/2011
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