Provider Demographics
NPI:1295211290
Name:PEREZ, STYL (DDS)
Entity type:Individual
Prefix:DR
First Name:STYL
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 PORT ROYALE DR S APT 205
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-7866
Mailing Address - Country:US
Mailing Address - Phone:978-912-2228
Mailing Address - Fax:
Practice Address - Street 1:2300 E LAS OLAS BLVD STE 3W
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-1578
Practice Address - Country:US
Practice Address - Phone:954-467-0303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23693122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist