Petty, John Adam
Petty, John Adam is an individual health care provider with primary practice located at 17821 Highway 7 Ste 2F , Minnetonka MN 55345-4113. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Petty, John Adam can be contacted via phone (952) 474-5622.Contact Information
Primary practice address
17821 Highway 7 Ste 2F
Minnetonka MN 55345-4113
Phone: (952) 474-5622
Fax: (952) 474-0283
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D11708 | Minnesota |
Profile Details
| NPI number | 1437211448 |
|---|---|
| LBN Legal business name | Petty, John Adam |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 15th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1437211448 | NPPES |
| Minnesota | MEDICAID | 54913400 |
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