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General NPI Number Information
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NPI Number | 1801406129
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Entity Type | Individual
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Provider Name | JACOB PERRY DMD
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Gender | Male
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Dates
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Enumeration Date | 08/01/2020
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 277 VETERANS PKWY
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City | MURFREESBORO
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State | TN
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Zip | 37128-1076
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Country | US
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Telephone | 615-713-1993
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Fax |
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Provider Business Mailing Address
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Address Line | 10706 EAGLE GLEN DR
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City | KNOXVILLE
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State | TN
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Zip | 37922-5566
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Country | US
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Telephone | 801-319-3219
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Fax |
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 11662
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License Number State | TN
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