Provider Demographics
NPI:1073740361
Name:PEREZ, ANDREA ERIKA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:ERIKA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HOLLYWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-1911
Mailing Address - Country:US
Mailing Address - Phone:516-557-9023
Mailing Address - Fax:
Practice Address - Street 1:2 HOLLYWOOD LN
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA PARK
Practice Address - State:NY
Practice Address - Zip Code:11762-1911
Practice Address - Country:US
Practice Address - Phone:516-557-9023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program