Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KYLE PETTERSEN, DDS
Active Sole ProprietorKYLE PETTERSEN, DDS is a General Dentistry healthcare provider located in LILBURN, Georgia. NPI 1275849986 is currently active in the NPPES registry. Verify at CMS.
General Dentistry · LILBURN, GA
Registration Details
- NPI Number
- 1275849986
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 19, 2010 (15.999206223583 yrs)
- Last Updated
- Mar 26, 2021
- Licenses
-
0025983 (TX)59547 (CA)DN016137 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
609 BEAVER RUIN RD NW # ALILBURN, GA, 300473401Browse GA providers · Browse ZIP 30047
- Phone
- 6786069407
- Primary Specialty
-
General Dentistry
1223G0001X
- Additional Specialty
- General Dentistry
- Additional Specialty
- General Dentistry
Other General Dentistry Providers in LILBURN, GA
| Name | Credential | NPI |
|---|---|---|
| DR. NAZNEEN SHAMIM DALWAI | D.M.D. | 1255366738 |
| DR. KEITH E. REYNOLDS | D.M.D. | 1578583530 |
| DR. CRAIG N FIEVET | DMD | 1376566547 |
| DR. RICHARD PETER GANGWISCH | D.D.S. | 1255355145 |
| DR. RICHARD GENE SEPMEYER | D.D.S. | 1790794501 |
| DR. HYE JUNG REGINA SUK | DMD | 1558372235 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.