Provider Demographics
NPI:1265691760
Name:PERKINS, GRETCHEN S (DMD)
Entity type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:S
Last Name:PERKINS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BRADFORD RD
Mailing Address - Street 2:SUITE 270
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-6909
Mailing Address - Country:US
Mailing Address - Phone:724-935-4210
Mailing Address - Fax:724-935-8853
Practice Address - Street 1:101 BRADFORD RD
Practice Address - Street 2:SUITE 270
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-6909
Practice Address - Country:US
Practice Address - Phone:724-935-4210
Practice Address - Fax:724-935-8853
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025730L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist