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General NPI Number Information
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NPI Number | 1912894106
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Entity Type | Individual
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Provider Name | SEAN PERRY DDS
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Gender | Male
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Dates
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Enumeration Date | 06/20/2025
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 1311 E CENTRAL DR
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City | MERIDIAN
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State | ID
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Zip | 83642-7991
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Country | US
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Telephone | 833-499-1813
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Fax |
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Provider Business Mailing Address
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Address Line | 236 E BLUELARK CT
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City | MERIDIAN
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State | ID
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Zip | 83642-5004
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Country | US
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Telephone | 704-929-4968
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2271562
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License Number State | ID
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