Individual
DR. JAMES LOUIS PETRAITIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
5769 SALTSBURG RD, VERONA, PA 15147-3211
(412) 795-5600
(412) 795-1172
Mailing address
5769 SALTSBURG RD, VERONA, PA 15147-3211
(412) 795-5600
(412) 795-1172
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DSO21328L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2561825027
IRS TIN
PA
01
—
DSO21328L
LICENSE #
PA
Enumeration date
11/01/2006
Last updated
07/08/2007
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