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General NPI Number Information
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NPI Number | 1508097817
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Entity Type | Individual
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Provider Name | DANIEL ENRIQUE PEREZ DDS
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Gender | Male
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Dates
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Enumeration Date | 08/04/2009
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 3580 KEAGY RD SW
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City | ROANOKE
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State | VA
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Zip | 24018-1152
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Country | US
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Telephone | 540-989-5257
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Fax |
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Provider Business Mailing Address
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Address Line | 3580 KEAGY RD SW
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City | ROANOKE
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State | VA
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Zip | 24018-1152
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Country | US
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Telephone | 540-989-5257
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | F-24895
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 0401419343
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License Number State | VA
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