Provider Demographics
NPI:1790904399
Name:PERRINE, T. RICHARD (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:T.
Middle Name:RICHARD
Last Name:PERRINE
Suffix:
Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:2300 WAYNE MEMORIAL DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-1726
Mailing Address - Country:US
Mailing Address - Phone:919-735-5999
Mailing Address - Fax:919-735-5963
Practice Address - Street 1:2300 WAYNE MEMORIAL DR
Practice Address - Street 2:SUITE C
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1726
Practice Address - Country:US
Practice Address - Phone:919-735-5999
Practice Address - Fax:919-735-5963
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC35911223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics