Individual
DR. CHARLES R. PETRIE I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6280 JACKSON DR, SUITE 6, SAN DIEGO, CA 92119-3434
(619) 466-0194
(619) 374-2110
Mailing address
6280 JACKSON DR, SUITE 6, SAN DIEGO, CA 92119-3434
(619) 466-0194
(619) 374-2110
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
24588
CA
Other
Enumeration date
09/24/2006
Last updated
07/08/2007
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