MEDICARE: DR. LARRY F PERKINS DDS, PA

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	6371	NC

General Provider Information

NPI Number	:	1386667004
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LARRY F PERKINS DDS, PA

Provider Business Mailing Address
First Line	:	5922 WEDDINGTON MONROE RD
Second Line	:	SUITE A-2
City	:	WESLEY CHAPEL
State	:	NC
Zip	:	28104-8202
Country	:	US
Telephone Number	:	704-843-5757
Fax Number	:	704-843-5041

Provider Business Practice Location Address
First Line	:	5922 WEDDINGTON MONROE RD
Second Line	:	SUITE A-2
City	:	WESLEY CHAPEL
State	:	NC
Zip	:	28104-8202
Country	:	US
Telephone Number	:	704-843-5757
Fax Number	:	704-843-5041

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	07/08/2007

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