Provider Demographics
NPI:1336333624
Name:PERRY, RONALD (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:
Last Name:PERRY
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1310
Mailing Address - Country:US
Mailing Address - Phone:781-331-9200
Mailing Address - Fax:781-331-9380
Practice Address - Street 1:1650 MAIN ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1310
Practice Address - Country:US
Practice Address - Phone:781-331-9200
Practice Address - Fax:781-331-9380
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA173511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice