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Individual

DR. CONRAD PETTIT MCVEA III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
2016 WASHINGTON ST, FRANKLINTON, LA 70438-2533
(985) 839-4138
(985) 839-6253
Mailing address
1022 NEEDLE RD, FRANKLINTON, LA 70438-2500
(985) 839-5500

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4294
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1842940
LA
Enumeration date
06/23/2005
Last updated
07/09/2007
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