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1912329830
GLEN O. PETTA
FORT WORTH, TX
NPI
1912329830
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: TX 12754)
Enumeration Date
2014-01-12
Last Update Date
2014-01-12
Business Address
Dr. GLEN O. PETTA DDS
3201 PRESTON HOLLOW RD
FORT WORTH, TX 76109-2052
Phone number: 817-312-9273
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Mailing Address
Dr. GLEN O. PETTA DDS
3201 PRESTON HOLLOW RD
FORT WORTH, TX 76109-2052
Phone number: 817-312-9273
Copy
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