Individual
DR. JEREK BRADFORD PETROUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
30201 DEQUINDRE RD, MADISON HEIGHTS, MI 48071-2284
(248) 219-4154
(248) 588-5610
Mailing address
30201 DEQUINDRE RD, MADISON HEIGHTS, MI 48071-2284
(248) 219-4154
(248) 588-5610
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2901020512
MI
Other
Enumeration date
07/27/2013
Last updated
07/27/2013
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