Organization
TIMOTHY J PETTIT, D.D.S., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY J PETTIT DDS (PRESIDENT)
(530) 662-3915
Entity
Organization
Contact information
Practice address
1204 COTTONWOOD ST STE 7, WOODLAND, CA 95695-4362
(530) 662-3915
(530) 662-9314
Mailing address
1204 COTTONWOOD ST STE 7, WOODLAND, CA 95695-4362
(530) 662-3915
(530) 662-9314
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
21494
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21494
STATE ID NUMBER
CA
Enumeration date
05/15/2007
Last updated
08/22/2020
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