Provider Demographics
NPI:1477812865
Name:PETTIGREW, WILLIAM ROBERT II (DDS)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ROBERT
Last Name:PETTIGREW
Suffix:II
Gender:M
Credentials:DDS
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Mailing Address - Street 1:7208 HODGSON MEMORIAL DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2512
Mailing Address - Country:US
Mailing Address - Phone:912-351-4555
Mailing Address - Fax:912-351-5051
Practice Address - Street 1:7208 HODGSON MEMORIAL DR
Practice Address - Street 2:SUITE A
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2512
Practice Address - Country:US
Practice Address - Phone:912-351-4555
Practice Address - Fax:912-351-5051
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-07
Last Update Date:2012-05-07
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Provider Licenses
StateLicense IDTaxonomies
GADN012876122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice