Individual
DR. MARK LOUIS PETTIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1060 E 100 S, SUITE 302, SALT LAKE CITY, UT 84102-1501
(801) 328-1633
(801) 328-4065
Mailing address
1060 E 100 S, SUITE 302, SALT LAKE CITY, UT 84102-1501
(801) 328-1633
(801) 328-4065
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2763579922
UT
Other
Enumeration date
09/28/2006
Last updated
03/19/2015
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