DENNIS G PETTIT DDS INC; NPI #1356667323

Contact Information

DENNIS G PETTIT DDS INC

1762 COMMERCE CENTER BLVD
FAIRBORN, OH 45324-6358

Phone: 937-878-8694
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Oral and Maxillofacial Surgery	261QS0112X

Indicates primary specialty

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NPI Profile & details for DENNIS G PETTIT DDS INC

NPI Number 1356667323

LBN Legal business name DENNIS G PETTIT DDS INC

Authorized official DENNIS PETTIT - (OWNER/PROVIDER)

Entity Organization

Organization subpart ¹ No

Enumeration date 04/15/2010

Last updated 04/23/2010 - About 16 years ago

Identifiers

OH	License #	30-01-8161
OH	Medicaid	0695609

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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