| Timothy J Pettit, D.d.s., Inc. | |
|
1204 Cottonwood St Ste 7 Woodland CA 95695-4362 | |
| (530) 662-3915 | |
| (530) 662-9314 |
| Full Name | Timothy J Pettit, D.d.s., Inc. |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1204 Cottonwood St Ste 7, Woodland, California |
| Authorized Official Name and Position | Timothy J Pettit (PRESIDENT) |
| Authorized Official Contact | 5306623915 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Timothy J Pettit, D.d.s., Inc. 1204 Cottonwood St Ste 7 Woodland CA 95695-4362 Ph: (530) 662-3915 | Timothy J Pettit, D.d.s., Inc. 1204 Cottonwood St Ste 7 Woodland CA 95695-4362 Ph: (530) 662-3915 |
| NPI Number | 1487860573 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487860573 | NPI | - | NPPES |
| 21494 | Other | CA | STATE ID NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 21494 (California) | Primary |
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