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1104957521
DAVID SHANE PETRIE
FAYETTEVILLE, GA
NPI
1104957521
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: GA 8534)
Enumeration Date
2007-03-08
Last Update Date
2007-07-08
Business Address
Dr. DAVID SHANE PETRIE DDS
320 N JEFF DAVIS DR STE B
FAYETTEVILLE, GA 30214-1669
Phone number: 770-461-3921
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Mailing Address
Dr. DAVID SHANE PETRIE DDS
320 N JEFF DAVIS DR STE B
FAYETTEVILLE, GA 30214-1669
Phone number: 770-461-3921
Copy
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