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General NPI Number Information
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NPI Number | 1508254871
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Entity Type | Organization
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Legal Business Name | KATE E. PERHAM DMD PC
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Dates
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Enumeration Date | 01/08/2015
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Last Update Date | 01/08/2015
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Provider Practice Location Address
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Address Line | 15 MAPLE AVE
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City | GLOVERSVILLE
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State | NY
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Zip | 12078-1413
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Country | US
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Telephone | 518-773-7584
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Fax | 518-725-0845
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Provider Business Mailing Address
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Address Line | 15 MAPLE AVE
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City | GLOVERSVILLE
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State | NY
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Zip | 12078-1413
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Country | US
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Telephone | 518-773-7584
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Fax | 518-725-0845
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Authorized Official
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Title or Position | DENTIST
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Name | DR. KATE E PERHAM
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Credential | DMD
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Telephone | 518-773-7584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 054923
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License Number State | NY
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