Provider Demographics
NPI:1265635676
Name:PERRY, CANDICE HARPER (DMD)
Entity Type:Individual
Prefix:DR
First Name:CANDICE
Middle Name:HARPER
Last Name:PERRY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 N 24TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-3206
Mailing Address - Country:US
Mailing Address - Phone:479-621-0226
Mailing Address - Fax:
Practice Address - Street 1:203 N 24TH ST STE D
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3206
Practice Address - Country:US
Practice Address - Phone:479-621-0226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3375-061223G0001X
AR40761223G0001X
AR371223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223G0001XDental ProvidersDentistGeneral Practice