Healthcare Provider Details

I. General information

NPI: 1326063488
Provider Name (Legal Business Name): DENNIS A PERRY SR. D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10506 MONTGOMERY RD SUITE 203
CINCINNATI OH
45242-4487
US

IV. Provider business mailing address

10506 MONTGOMERY RD SUITE 203
CINCINNATI OH
45242-4487
US

V. Phone/Fax

Practice location:
  • Phone: 513-791-0550
  • Fax: 513-791-1517
Mailing address:
  • Phone: 513-791-0550
  • Fax: 513-791-1517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number30018720
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: