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1235322108
GLEN H PETTEWAY
SPRINGFIELD, MO
NPI
1235322108
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223P0700X Dentist, Prosthodontics
(Licence: MO 13801-00673)
Enumeration Date
2007-08-23
Last Update Date
2007-08-23
Business Address
Dr. GLEN H PETTEWAY DDS
1200 E WOODHURST STE T300
SPRINGFIELD, MO 65804-3784
Phone number: 417-887-7114
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Mailing Address
Dr. GLEN H PETTEWAY DDS
1200 E WOODHURST STE T300
SPRINGFIELD, MO 65804-3784
Phone number: 417-887-7114
Copy
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