David Shane Petrie, DDS

Dentist · Fayetteville, GA

Individual Active NPI

NPI number 1104957521

Practice location

320 N Jeff Davis Dr Ste B
Fayetteville, GA 30214-1669
Phone
(770) 461-3921
Fax
(770) 461-0944

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NPI record

NPI
1104957521
Entity type
Individual (Type 1)
Enumeration date
March 8, 2007
Last updated
July 8, 2007
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 8534 GA

About Dr. Petrie

David Shane Petrie, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 320 N Jeff Davis Dr Ste B, Fayetteville, GA 30214-1669. The NPI number 1104957521 was assigned on March 8, 2007 and the record was last updated on July 8, 2007.

Dr. Petrie lists a license in the registry: #8534 (GA) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of David Shane Petrie, DDS?

The NPI number is 1104957521.

What is the phone number of Dr. Petrie?

The phone number listed for the practice location is (770) 461-3921.

Where is Dr. Petrie located?

320 N Jeff Davis Dr Ste B, Fayetteville, GA 30214-1669.

What is the taxonomy code for Dr. Petrie?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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