Provider Demographics
NPI:1104018803
Name:JAMES M PEERY JR DDS PC
Entity Type:Organization
Organization Name:JAMES M PEERY JR DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:PEERY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:434-847-5331
Mailing Address - Street 1:2104 LANGHORNE RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-1424
Mailing Address - Country:US
Mailing Address - Phone:434-847-5331
Mailing Address - Fax:434-847-6665
Practice Address - Street 1:2104 LANGHORNE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1424
Practice Address - Country:US
Practice Address - Phone:434-847-5331
Practice Address - Fax:434-847-6665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010049141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty