Provider Demographics
NPI:1356357123
Name:PERRIN, WILSON BARTON (DDS)
Entity type:Individual
Prefix:DR
First Name:WILSON
Middle Name:BARTON
Last Name:PERRIN
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 1:737 EVERHART RD
Mailing Address - Street 2:SUITE B.
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1924
Mailing Address - Country:US
Mailing Address - Phone:361-992-7631
Mailing Address - Fax:
Practice Address - Street 1:737 EVERHART RD
Practice Address - Street 2:SUITE B.
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1924
Practice Address - Country:US
Practice Address - Phone:361-992-7631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice