Pettigrew, James C
Pettigrew, James C is an individual health care provider with primary practice located at 1600 Sw Archer Rd , Gainesville FL 32610-3003. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, Dental Providers / Oral and Maxillofacial Radiology. Dental Providers / Oral and Maxillofacial Radiology is his primary health care specialty. Pettigrew, James C can be contacted via phone (352) 273-6775.Contact Information
Primary practice address
1600 Sw Archer Rd
Gainesville FL 32610-3003
Phone: (352) 273-6775
Fax: (352) 392-2507
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | DTP312 | Florida |
Dental Providers / Oral and Maxillofacial Radiology | 1223X0008X | DTP312 | Florida |
Profile Details
NPI number | 1689643264 |
---|---|
LBN Legal business name | Pettigrew, James C |
Credentials | Doctor of Dental Medicine (DMD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 16th, 2006 |
Last updated | Apr 23rd, 2008 - about 16 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1689643264 | NPPES |
Florida | MEDICAID | 73322900 | |
Florida | MEDICAID | 073322900 |
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