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General NPI Number Information
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NPI Number | 1548344476
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Entity Type | Individual
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Provider Name | ROBERT LEE PERLOT JR. D.M.D, M.S.
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/06/2013
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Provider Practice Location Address
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Address Line | 1415 HARRISON AVE. N.W. SUITE 202
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City | OLYMPIA
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State | WA
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Zip | 98502
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Country | US
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Telephone | 360-786-1600
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Fax | 360-705-2116
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Provider Business Mailing Address
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Address Line | 1415 HARRISON AVE NW SUITE 202
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City | OLYMPIA
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State | WA
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Zip | 98502-5332
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Country | US
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Telephone | 360-786-1600
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Fax | 360-705-2116
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS030408L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DE60115081
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License Number State | WA
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