MEDICARE: JOSEPH JAMES PERRY D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	13669	TX

General Provider Information

NPI Number	:	1174530380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH JAMES PERRY D.D.S.

Provider Business Mailing Address
First Line	:	7300 BLANCO RD STE 203
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-4938
Country	:	US
Telephone Number	:	210-349-3745
Fax Number	:	210-349-3898

Provider Business Practice Location Address
First Line	:	7300 BLANCO RD STE 203
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-4938
Country	:	US
Telephone Number	:	210-349-3745
Fax Number	:	210-349-3898

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	03/17/2018

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