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General NPI Number Information
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NPI Number | 1902431836
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Entity Type | Organization
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Legal Business Name | ROBERT SHAUN PERRY DDS MPH INC
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Dates
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Enumeration Date | 03/11/2020
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Last Update Date | 03/20/2020
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Provider Practice Location Address
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Address Line | 1400 REYNOLDS AVE STE 110
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City | IRVINE
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State | CA
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Zip | 92614-5562
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Country | US
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Telephone | 949-508-2626
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 REYNOLDS AVE STE 110
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City | IRVINE
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State | CA
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Zip | 92614-5562
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LAURA CARR
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Credential |
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Telephone | 949-508-2625
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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