Provider Demographics
NPI:1710194758
Name:PERIMENIS, RORY T (DDS)
Entity Type:Individual
Prefix:MR
First Name:RORY
Middle Name:T
Last Name:PERIMENIS
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 1:324 ELM STREET
Mailing Address - Street 2:SUITE 201A
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468
Mailing Address - Country:US
Mailing Address - Phone:203-459-8990
Mailing Address - Fax:203-261-3187
Practice Address - Street 1:324 ELM STREET
Practice Address - Street 2:SUITE 201A
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468
Practice Address - Country:US
Practice Address - Phone:203-459-8990
Practice Address - Fax:203-261-3187
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6699122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist