Provider Demographics
NPI:1407433949
Name:PERRY DENTAL SOLUTIONS
Entity Type:Organization
Organization Name:PERRY DENTAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:FILUTZE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:440-639-2273
Mailing Address - Street 1:3933 LANE RD
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-4902
Mailing Address - Country:US
Mailing Address - Phone:440-639-2273
Mailing Address - Fax:440-357-1646
Practice Address - Street 1:3933 LANE ROAD
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:OH
Practice Address - Zip Code:44081
Practice Address - Country:US
Practice Address - Phone:440-639-2273
Practice Address - Fax:440-357-1646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No122300000XDental ProvidersDentistGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty