Provider Demographics
NPI:1184609695
Name:PERLMAN, STEVEN P (DDS, MSCD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:P
Last Name:PERLMAN
Suffix:
Gender:M
Credentials:DDS, MSCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 233
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-0333
Mailing Address - Country:US
Mailing Address - Phone:781-599-2900
Mailing Address - Fax:781-598-1670
Practice Address - Street 1:77 BROAD ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-5003
Practice Address - Country:US
Practice Address - Phone:781-599-2900
Practice Address - Fax:781-598-1670
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA124431223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0248223Medicaid