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General NPI Number Information
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NPI Number | 1407433949
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Entity Type | Organization
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Legal Business Name | PERRY DENTAL SOLUTIONS
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Dates
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Enumeration Date | 03/29/2021
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Last Update Date | 03/29/2021
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Provider Practice Location Address
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Address Line | 3933 LANE ROAD
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City | PERRY
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State | OH
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Zip | 44081
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Country | US
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Telephone | 440-639-2273
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Fax | 440-357-1646
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Provider Business Mailing Address
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Address Line | 3933 LANE RD
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City | PAINESVILLE
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State | OH
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Zip | 44077-4902
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Country | US
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Telephone | 440-639-2273
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Fax | 440-357-1646
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JOHN FILUTZE
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Credential | DDS
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Telephone | 440-639-2273
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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