Dr. Dennis G Pettit
Oral and Maxillofacial Surgeon Oral and Maxillofacial Pathology
1762 Commerce Center Blvd
Fairborn
, Ohio 45324-6358
Dr. Dennis G Pettit
Oral and Maxillofacial Surgeon Oral and Maxillofacial Pathology
1762 Commerce Center Blvd
Fairborn
, Ohio 45324-6358
(937) 878-1554
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About
Features
Specialties
- Oral and Maxillofacial Pathology
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Dennis G Pettit
- 1762 Commerce Center Blvd
- Fairborn, OH
- Zip : 45324
- Fax : (937) 878-1554
- Phone : (937) 878-8694
Second Address
- Dr. Dennis G Pettit
- 1762 Commerce Center Blvd
- Fairborn, OH
- Zip : 45324-6358
- Phone : (937) 878-8694
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | 30018161 | OH |
| N | 1223S0112X | Oral and Maxillofacial Surgeon | 30-01-8161 | OH |
National Provider Identifier
| NPI | 1356354765 |
|---|---|
| Provider Name | Dr. Dennis G Pettit |
| First Address | Fairborn, OH 45324 |
| Second Address | Fairborn, OH 45324-6358 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/08/2006 |
| Last Update Date | 12/08/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0695609 | (05) | OH |
| U17952 | (02) | OH |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.