Doctor Name: | DR. PETULA HOM-MINNITI |
NPI Number: | 1033264742 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DDS |
License Number: | DN012900 |
Business Practice Address: | 270 Saint Claire Dr Suite 104 Alpharetta, GA - 300045728 |
Business Phone Number: | 6789908592 |
Business Fax Number: | 6789908594 |
Mailing Address: | 270 Saint Claire Dr, Suite 104 ALPHARETTA |
State: | GA |
Postal Code: | 300045728 |
Phone Number: | 6789908592 |
Fax Number: | 6789908594 |
NPI Enumeration Date: | 01/24/2007 |
NPI Last Update Date: | 09/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | DN012900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |