Individual
DR. REBECCA PETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
9601 CHESTER AVE, CLEVELAND, OH 44106
(216) 368-8665
Mailing address
30842 KILGOUR DR, WESTLAKE, OH 44145-6835
(440) 226-0097
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
RES.004157
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RES.004157
—
OH
Enumeration date
06/24/2019
Last updated
06/24/2019
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