Provider Demographics
NPI:1699215202
Name:LARA A PERRY DDS PA
Entity Type:Organization
Organization Name:LARA A PERRY DDS PA
Other - Org Name:HILL COUNTRY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LARA
Authorized Official - Middle Name:ALEXANDRA
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-379-8902
Mailing Address - Street 1:1778 S WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-1127
Mailing Address - Country:US
Mailing Address - Phone:830-626-1002
Mailing Address - Fax:830-626-1004
Practice Address - Street 1:1778 S WALNUT AVE
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-1127
Practice Address - Country:US
Practice Address - Phone:830-626-1002
Practice Address - Fax:830-626-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty