Individual
DR. JOHN ADAM PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
17821 HIGHWAY 7 STE 2F, MINNETONKA, MN 55345-4113
(952) 474-5622
(952) 474-0283
Mailing address
11256 DEER RIDGE LN, MINNETONKA, MN 55343-4122
(952) 933-9614
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11708
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54913400
—
MN
Enumeration date
12/15/2006
Last updated
07/08/2007
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