Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DS019772L | PA |
NPI | 1023114493 |
---|---|
Provider Name | Mr. Dennis Anthony Perry |
First Address | Pittsburgh, PA 15243 |
Second Address | Pittsburgh, PA 15243 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 08/07/2007 |