Individual
DR. DENNIS G PETTIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1762 COMMERCE CENTER BLVD, FAIRBORN, OH 45324-6358
(937) 878-8694
Mailing address
1762 COMMERCE CENTER BLVD, FAIRBORN, OH 45324
(937) 878-8694
(937) 878-1554
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
30018161
OH
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
30-01-8161
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0695609
—
OH
Enumeration date
08/15/2006
Last updated
08/12/2008
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