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General NPI Number Information
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NPI Number | 1306207113
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Entity Type | Organization
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Legal Business Name | PAUL PERPICH, DDS
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Dates
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Enumeration Date | 03/08/2016
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Last Update Date | 03/08/2016
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Provider Practice Location Address
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Address Line | 5461 CITY HALL ST
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City | NISSWA
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State | MN
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Zip | 56468-2478
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Country | US
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Telephone | 218-546-5809
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 464 338 CURTIS AVE.
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City | IRONTON
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State | MN
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Zip | 56455
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Country | US
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Telephone | 218-546-5809
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Fax | 218-772-0239
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. PAUL M PERPICH
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Credential | DDS
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Telephone | 218-546-5809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 9410
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License Number State | MN
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