MEDICARE: PERRY DENTISTRY

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	122300000X	Dentist

General Provider Information

NPI Number	:	1841620077
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERRY DENTISTRY

Provider Business Mailing Address
First Line	:	6150 ELDORADO PKWY
Second Line	:	SUITE 150
City	:	MCKINNEY
State	:	TX
Zip	:	75070-5622
Country	:	US
Telephone Number	:	972-540-7500
Fax Number	:	972-369-0267

Provider Business Practice Location Address
First Line	:	6150 ELDORADO PKWY
Second Line	:	SUITE 150
City	:	MCKINNEY
State	:	TX
Zip	:	75070-5622
Country	:	US
Telephone Number	:	972-540-7500
Fax Number	:	972-369-0267

Authorized Official
Title or Position	:	DENTIST
Name	:	SVETLANA PERRY
Credential	:	D.O
Telephone Number	:	972-540-7500

Provider Enumeration Date	:	11/26/2013
Last Update Date	:	11/26/2013

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