Provider Demographics
NPI:1346406790
Name:PERKINS, DAVID W (DMD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:PERKINS
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 1:524 MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-7441
Mailing Address - Country:US
Mailing Address - Phone:860-589-7595
Mailing Address - Fax:860-585-9550
Practice Address - Street 1:524 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-7441
Practice Address - Country:US
Practice Address - Phone:860-589-7595
Practice Address - Fax:860-585-9550
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5806122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist