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Timothy David Petty, DMD
General Practice Dentistry in Pueblo, Colorado
NPI 1699418921

Timothy David Petty is a General Practice Dentistry based in Denver, CO and is specialized in General Practice. Timothy David Petty practices in Pueblo, CO and has the professional credentials of DMD. The NPI Number for Timothy David Petty is 1699418921 and holds a License No. (Colorado).

The current practice location address for Timothy David Petty is 1800 Fortino Blvd Unit 1, Pueblo, CO and can be reached out via phone at 719-545-1400.

Location: 1800 Fortino Blvd Unit 1, Pueblo, CO, 80222-7139
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1699418921
Provider Name
Timothy David Petty
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
1800 Fortino Blvd Unit 1, Pueblo, CO, 80222-7139
Phone Number
719-545-1400
Fax Number
Provider Enumeration Date
04/14/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1800 Fortino Blvd Unit 1
City
Pueblo
State
Colorado
Zip
81008-1891
Phone Number
719-545-1400
Fax Number
person
Provider Business Mailing Address Details
Address
1800 Fortino Blvd Unit 1
City
Pueblo
State
Colorado
Zip
81008-1891
Phone Number
719-545-1400
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
DEN.00205534 (Colorado)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
(New Mexico)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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