Organization
KAREN Y. PETTY, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAREN PETTY DDS (DENTIST)
(919) 875-1630
Entity
Organization
Contact information
Practice address
310 W MILLBROOK RD, SUITE 100, RALEIGH, NC 27609-4306
(919) 875-1630
(919) 875-1629
Mailing address
310 W MILLBROOK RD, SUITE 100, RALEIGH, NC 27609-4306
(919) 875-1630
(919) 875-1629
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6633
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
899016E
BCBS
NC
05
—
899016E
—
NC
05
—
8996848
—
NC
Enumeration date
03/25/2008
Last updated
03/25/2008
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