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NPI Code Detail

MEDICARE: DR. ANTHONY J. PETRO DDS

MEDICARE:  DR. ANTHONY J. PETRO  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry30-016195OH

General Provider Information

NPI Number : 1821160557
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANTHONY J. PETRO DDS
Provider Business Mailing Address
First Line : 6659 PEARL RD
Second Line : SUITE 403
City : PARMA HEIGHTS
State : OH
Zip : 44130-3821
Country : US
Telephone Number : 440-843-8200
Fax Number :
Provider Business Practice Location Address
First Line : 6659 PEARL RD
Second Line : SUITE 403
City : PARMA HEIGHTS
State : OH
Zip : 44130-3821
Country : US
Telephone Number : 440-843-8200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2006
Last Update Date : 07/08/2007

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Directions to “ DR. ANTHONY J. PETRO DDS” Practice Location

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