Provider Demographics
NPI:1356431399
Name:PEREZ, GERRY B (DMD)
Entity type:Individual
Prefix:DR
First Name:GERRY
Middle Name:B
Last Name:PEREZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 CONNELLSVILLE ST
Mailing Address - Street 2:
Mailing Address - City:DUNBAR
Mailing Address - State:PA
Mailing Address - Zip Code:15431-1536
Mailing Address - Country:US
Mailing Address - Phone:724-277-0202
Mailing Address - Fax:
Practice Address - Street 1:43 CONNELLSVILLE ST
Practice Address - Street 2:
Practice Address - City:DUNBAR
Practice Address - State:PA
Practice Address - Zip Code:15431-1536
Practice Address - Country:US
Practice Address - Phone:724-277-0202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028337L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist