Individual
LAUREN PETTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1641 MAHAN CENTER BLVD STE 1, TALLAHASSEE, FL 32308-7404
(850) 309-0333
Mailing address
740 VIOLET ST, TALLAHASSEE, FL 32308-6245
(850) 517-6290
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN29372
FL
Other
Enumeration date
07/12/2024
Last updated
07/12/2024
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