Individual
DR. WILLIAM J PETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1105 S 13TH ST STE 200, NORFOLK, NE 68701-5767
(402) 371-3745
(402) 379-9265
Mailing address
1105 S 13TH ST STE 200, NORFOLK, NE 68701-5767
(402) 371-3745
(402) 379-9265
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4826
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
470625718
DELTA
MN
01
—
5437
BLUE CROSS BLUE SHIELD
NE
Enumeration date
09/01/2006
Last updated
12/11/2015
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