Provider Demographics
NPI:1093777153
Name:PERRY, PATRICK J (DMD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:J
Last Name:PERRY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4835 OAKHURST AVE
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-8392
Mailing Address - Country:US
Mailing Address - Phone:724-449-0045
Mailing Address - Fax:
Practice Address - Street 1:4835 OAKHURST AVE
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-8392
Practice Address - Country:US
Practice Address - Phone:724-449-0045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2011-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS022720L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice