Petricig, Heather N.

Petricig, Heather N. is an sole proprietor health care provider with primary practice located at 1101 S Columbia Rd Ste B , Grand Forks ND 58201-4055. She recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dentist. Dental Providers / Dentist is her primary health care specialty. Petricig, Heather N. can be contacted via phone (218) 230-4352.

Contact Information

Primary practice address
1101 S Columbia Rd Ste B Grand Forks ND 58201-4055
Phone: (218) 230-4352
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 6419 Wisconsin
Dental Providers / Dentist 122300000X 2083 North Dakota

Profile Details

NPI number 1134358476
LBN Legal business name Petricig, Heather N.
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 8th, 2009
Last updated Mar 10th, 2011 - about 15 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 1134358476 NPPES
North Dakota MEDICAID 41564

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