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General NPI Number Information
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NPI Number | 1215297023
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Entity Type | Individual
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Provider Name | KELLY J PERRY D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/25/2012
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Last Update Date | 02/26/2015
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Provider Practice Location Address
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Address Line | 100 ROBIE RD
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City | BRISTOL
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State | NH
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Zip | 03222-6063
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Country | US
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Telephone | 603-744-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 101 BOULDER POINT DR
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City | PLYMOUTH
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State | NH
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Zip | 03264-3170
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Country | US
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Telephone | 603-536-4000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 61316
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License Number State | CA
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