Individual
DEREK ANDREW PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4050 W INTERSTATE 20, ARLINGTON, TX 76017-1435
(903) 519-9134
Mailing address
2801 LIVE OAK ST APT 5203, DALLAS, TX 75204-5732
(903) 519-9134
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
36800
TX
Other
Enumeration date
01/12/2021
Last updated
01/12/2021
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