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Individual

MRS. DONNA JEAN PETRO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1324 TIPPECANOE ST, LAFAYETTE, IN 47904-2051
(765) 742-1567
(765) 429-2794
Mailing address
1324 TIPPECANOE ST, LAFAYETTE, IN 47904-2051
(765) 742-1567
(765) 429-2794

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
13002646A
IN

Other

Enumeration date
02/09/2023
Last updated
02/09/2023
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