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:
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Health care specialties

SpecialtyCodeLicense #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 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689643264 NPPES
Florida MEDICAID 73322900
Florida MEDICAID 073322900

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