Provider Demographics
NPI:1336467828
Name:PERRY, ANDREW T (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:T
Last Name:PERRY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6829 FALLS OF NEUSE RD STE 106
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-5385
Mailing Address - Country:US
Mailing Address - Phone:919-870-5905
Mailing Address - Fax:919-870-8194
Practice Address - Street 1:6829 FALLS OF NEUSE RD STE 106
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5385
Practice Address - Country:US
Practice Address - Phone:919-870-5905
Practice Address - Fax:919-870-8194
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-10
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8753332B00000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies