Provider Demographics
NPI:1043222631
Name:PERRY, ELIZABETH SHIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:SHIN
Last Name:PERRY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:53 SOUTHAMPTON RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085
Mailing Address - Country:US
Mailing Address - Phone:413-562-3900
Mailing Address - Fax:413-562-3535
Practice Address - Street 1:53 SOUTHAMPTON RD
Practice Address - Street 2:SUITE 6
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085
Practice Address - Country:US
Practice Address - Phone:413-562-3900
Practice Address - Fax:413-562-3535
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA181731223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics