Provider Demographics
NPI:1245527100
Name:PETRIE, ARVIND JEFFREY (DMD)
Entity type:Individual
Prefix:DR
First Name:ARVIND
Middle Name:JEFFREY
Last Name:PETRIE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3722 S VIRGINIA LN
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-8414
Mailing Address - Country:US
Mailing Address - Phone:206-351-6940
Mailing Address - Fax:
Practice Address - Street 1:82 E FRANCIS AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-1070
Practice Address - Country:US
Practice Address - Phone:509-484-4746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE602338481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice