Provider Demographics
NPI:1497485502
Name:PERRY, DREW CHRISTIAN (DDS)
Entity Type:Individual
Prefix:
First Name:DREW
Middle Name:CHRISTIAN
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 1:791 ROBERTS DR
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:AR
Mailing Address - Zip Code:71655-5724
Mailing Address - Country:US
Mailing Address - Phone:870-367-1123
Mailing Address - Fax:870-224-0107
Practice Address - Street 1:791 ROBERTS DR
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:AR
Practice Address - Zip Code:71655-5724
Practice Address - Country:US
Practice Address - Phone:870-367-1123
Practice Address - Fax:870-224-0107
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4609122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist