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General NPI Number Information
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NPI Number | 1679131098
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Entity Type | Individual
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Provider Name | RAUL A PEREZ DMD, MS
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Gender | Male
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Dates
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Enumeration Date | 05/31/2019
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | 2600 N MILITARY TRL STE 310
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City | BOCA RATON
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State | FL
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Zip | 33431-6315
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Country | US
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Telephone | 561-997-4080
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Fax |
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Provider Business Mailing Address
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Address Line | 630 E WOOLBRIGHT RD APT 403
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-6234
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Country | US
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Telephone | 561-319-5076
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Fax | 561-319-5076
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN24138
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN24138
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License Number State | FL
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