Provider Demographics
NPI:1013023050
Name:ASSOCIATES IN PERIODONTICS, PC
Entity Type:Organization
Organization Name:ASSOCIATES IN PERIODONTICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:PERL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:860-236-2566
Mailing Address - Street 1:61 S MAIN ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2486
Mailing Address - Country:US
Mailing Address - Phone:860-236-2566
Mailing Address - Fax:860-236-2282
Practice Address - Street 1:61 S MAIN ST
Practice Address - Street 2:SUITE 301
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2486
Practice Address - Country:US
Practice Address - Phone:860-236-2566
Practice Address - Fax:860-236-2282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT37651223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty