Petrie, Jamie

Petrie, Jamie is an individual health care provider with primary practice located at 905 Franklin St , Waterloo IA 50703-4407. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Petrie, Jamie can be contacted via phone (319) 272-4300.

Contact Information

Primary practice address
905 Franklin St Waterloo IA 50703-4407
Phone: (319) 272-4300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 08561 Iowa

Profile Details

NPI number 1629232822
LBN Legal business name Petrie, Jamie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2008
Last updated Jul 16th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629232822 NPPES
Iowa MEDICAID 0076372

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