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General NPI Number Information
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NPI Number | 1679792147
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Entity Type | Individual
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Provider Name | PAUL M PERPICH DDS
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Gender | Male
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 5461 CITY HALL
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City | NISSWA
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State | MN
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Zip | 56468
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Country | US
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Telephone | 218-963-4448
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Fax | 218-546-5809
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Provider Business Mailing Address
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Address Line | PO BOX 8
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City | NISSWA
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State | MN
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Zip | 56468-0008
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Country | US
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Telephone | 218-963-4448
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Fax | 218-546-5809
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9410
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License Number State | MN
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