Provider Demographics
NPI:1760499289
Name:DURANT, PERRY WALKER (DMD)
Entity Type:Individual
Prefix:DR
First Name:PERRY
Middle Name:WALKER
Last Name:DURANT
Suffix:
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 1:154 SEA ISLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29907-1502
Mailing Address - Country:US
Mailing Address - Phone:843-986-0177
Mailing Address - Fax:843-986-0644
Practice Address - Street 1:154 SEA ISLAND PKWY
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29907-1502
Practice Address - Country:US
Practice Address - Phone:843-986-0177
Practice Address - Fax:843-986-0644
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice