MEDICARE: DR. DAVID PEREZ DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2295	PR

General Provider Information

NPI Number	:	1144216003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID PEREZ DMD

Provider Business Mailing Address
First Line	:	PORTICOS DE GUAYNABO
Second Line	:	APT 4101
City	:	GUAYNABO
State	:	PR
Zip	:	00971-9201
Country	:	US
Telephone Number	:	787-790-2410
Fax Number	:

Provider Business Practice Location Address
First Line	:	44 CALLE BARCELO
Second Line	:
City	:	CIDRA
State	:	PR
Zip	:	00739-3442
Country	:	US
Telephone Number	:	787-739-4501
Fax Number	:	787-739-4501

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	07/08/2007

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