Provider Demographics
NPI:1477584852
Name:PERRY, WARREN SEIPP JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:SEIPP
Last Name:PERRY
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:400 GLENWOOD AVE
Mailing Address - Street 2:SUITE 17
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-3851
Mailing Address - Country:US
Mailing Address - Phone:252-523-4927
Mailing Address - Fax:252-523-4078
Practice Address - Street 1:400 GLENWOOD AVE
Practice Address - Street 2:SUITE 17
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-3851
Practice Address - Country:US
Practice Address - Phone:252-523-4927
Practice Address - Fax:252-523-4078
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC45251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8996833Medicaid
NC4525OtherSTATE LISENCE
NC96833OtherBCBS