MEDICARE: EDWARD H. PERKL, DDS, PS

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	DE00004970	WA

General Provider Information

NPI Number	:	1881860864
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDWARD H. PERKL, DDS, PS

Provider Business Mailing Address
First Line	:	19718 68TH AVE W
Second Line	:	SUITE F
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-5965
Country	:	US
Telephone Number	:	425-778-2126
Fax Number	:	425-775-2329

Provider Business Practice Location Address
First Line	:	19718 68TH AVE W
Second Line	:	SUITE F
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-5965
Country	:	US
Telephone Number	:	425-778-2126
Fax Number	:	425-775-2329

Authorized Official
Title or Position	:	DENTIST/PRESIDENT
Name	:	DR. EDWARD H PERKL
Credential	:	DDS
Telephone Number	:	425-778-2126

Provider Enumeration Date	:	04/30/2008
Last Update Date	:	04/30/2008

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