Provider Demographics
NPI:1962630137
Name:PERKINS, LINDSAY B
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:B
Last Name:PERKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 SE 8TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-3289
Mailing Address - Country:US
Mailing Address - Phone:239-574-2000
Mailing Address - Fax:239-574-1144
Practice Address - Street 1:1435 SE 8TH TER
Practice Address - Street 2:SUITE A
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-3289
Practice Address - Country:US
Practice Address - Phone:239-574-2000
Practice Address - Fax:239-574-1144
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN187871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice