Provider Demographics
NPI:1790745206
Name:PETRONE, JOSEPH FELIX ANTHONY (DDS, MSD, MPH)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:FELIX ANTHONY
Last Name:PETRONE
Suffix:
Gender:M
Credentials:DDS, MSD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 TERRACE STREET
Mailing Address - Street 2:#3189
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15261-0001
Mailing Address - Country:US
Mailing Address - Phone:412-648-9100
Mailing Address - Fax:
Practice Address - Street 1:3501 TERRACE STREET
Practice Address - Street 2:#3189
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15261-0001
Practice Address - Country:US
Practice Address - Phone:412-648-9100
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025475L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics