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General NPI Number Information
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NPI Number | 1700922382
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Entity Type | Organization
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Legal Business Name | PERRY Y JUE DMD INC
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 01/05/2012
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Provider Practice Location Address
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Address Line | 5101 COMMERCE DRIVE SUITE #102
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0413
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Country | US
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Telephone | 661-323-1500
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Fax | 661-323-1767
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Provider Business Mailing Address
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Address Line | 5101 COMMERCE DRIVE SUITE #102
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0413
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Country | US
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Telephone | 661-323-1500
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Fax | 661-323-1767
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Authorized Official
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Title or Position | SHAREHOLDER
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Name | DR. PERRY Y JUE
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Credential |
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Telephone | 661-323-1500
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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 | 41430
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License Number State | CA
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