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NPI Profile for Dr GLEN H PETTEWAY in SPRINGFIELD, MO.
That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Prosthodontics |
1223P0700X |
| NPI # | 1235322108 |
|
| Status | Active | |
| Credentials | DDS (Doctor of Dental Surgery) | |
| Entity | Individual | |
| Enumeration date | 08/23/2007 | |
| Last updated | 08/23/2007 - About 19 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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GLEN H PETTEWAY
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GLEN H PETTEWAY, DDS