Individual
DR. GREGORY D. PETRILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
590 INDIAN SPRINGS RD, INDIANA, PA 15701-3600
(724) 465-6100
(724) 465-6110
Mailing address
100 SHENANGO AVE, SHARON, PA 16146-1503
(724) 465-6100
(724) 465-6110
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS039264
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102747929
—
PA
05
—
1027479290001
—
PA
05
—
1027479290002
—
PA
05
—
1027479290003
—
PA
Enumeration date
07/23/2012
Last updated
08/16/2019
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