Individual
LORI JOHNSON PETREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1213 N MAIN ST, FUQUAY VARINA, NC 27526-2616
(910) 814-2944
Mailing address
937 S HAWTHORNE RD, WINSTON SALEM, NC 27103-4416
(336) 722-5897
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
7541
NC
1223G0001X
General Practice Dentistry
Primary
D011603
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89902H2
—
NC
Enumeration date
01/16/2007
Last updated
02/16/2023
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