Provider Demographics
NPI:1366557936
Name:PETROFF, PATRICIA M (DMD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:PETROFF
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 OAK KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2229
Mailing Address - Country:US
Mailing Address - Phone:330-668-1160
Mailing Address - Fax:
Practice Address - Street 1:2800 S ARLINGTON RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-4702
Practice Address - Country:US
Practice Address - Phone:330-644-8423
Practice Address - Fax:330-644-0884
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA193591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice