Individual
DR. AMANDA NICOLE PETRIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2830 HWY 52, STE 360, MONCKS CORNER, SC 29461
(439) 904-7158
Mailing address
504 SOUND DR, SUMMERVILLE, SC 29486-2932
(570) 862-3684
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
13534
CT
1223G0001X
General Practice Dentistry
Primary
DGD.10656
SC
Other
Enumeration date
08/01/2022
Last updated
11/01/2023
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