Individual
DR. JEROD PAUL PETRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2900 MOSS ST, SUITE D, LAFAYETTE, LA 70501
(337) 233-5494
(337) 233-6150
Mailing address
2900 MOSS ST, SUITE D, LAFAYETTE, LA 70501
(337) 233-5494
(337) 233-6150
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
5653
LA
1223G0001X
General Practice Dentistry
Primary
5653
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1856533
—
LA
Enumeration date
06/01/2006
Last updated
09/11/2025
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