Individual
DR. JERILYN A. PETROVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5011
Mailing address
PO BOX 5177, PHOENIX, AZ 85010-5177
(602) 344-5651
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2209
AZ
Other
Enumeration date
11/17/2005
Last updated
07/08/2007
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