Provider Demographics
NPI:1740603596
Name:G A PERRY DDS KEENE
Entity Type:Organization
Organization Name:G A PERRY DDS KEENE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:603-357-0677
Mailing Address - Street 1:391 WEST STREET
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431
Mailing Address - Country:US
Mailing Address - Phone:603-357-0677
Mailing Address - Fax:603-354-7862
Practice Address - Street 1:391 WEST ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431
Practice Address - Country:US
Practice Address - Phone:603-357-0677
Practice Address - Fax:603-354-7862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-30
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2624122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty