Provider Demographics
NPI:1679956890
Name:PEREZ, ARTURO JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:ARTURO
Middle Name:
Last Name:PEREZ
Suffix:JR
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 1:1347 N BRIAN AVE
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-1802
Mailing Address - Country:US
Mailing Address - Phone:478-714-6765
Mailing Address - Fax:
Practice Address - Street 1:1025 PARK AVE UNIT 1
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-3623
Practice Address - Country:US
Practice Address - Phone:478-714-6765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA1051871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program