Provider Demographics
NPI:1578798427
Name:PERKINS DENTISTRY, INC
Entity Type:Organization
Organization Name:PERKINS DENTISTRY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:J
Authorized Official - Middle Name:CARTER
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:352-427-4532
Mailing Address - Street 1:11653 N WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:DUNNELLON
Mailing Address - State:FL
Mailing Address - Zip Code:34432-5890
Mailing Address - Country:US
Mailing Address - Phone:352-489-8433
Mailing Address - Fax:352-489-8477
Practice Address - Street 1:11653 N WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:DUNNELLON
Practice Address - State:FL
Practice Address - Zip Code:34432-5890
Practice Address - Country:US
Practice Address - Phone:352-489-8433
Practice Address - Fax:352-489-8477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN111801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty