Provider Demographics
NPI:1649312703
Name:UHAZIE, PERRY CHARLES (DDS)
Entity type:Individual
Prefix:DR
First Name:PERRY
Middle Name:CHARLES
Last Name:UHAZIE
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:DOCTORS PARK
Mailing Address - Street 2:204
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829
Mailing Address - Country:US
Mailing Address - Phone:906-786-3159
Mailing Address - Fax:906-786-2952
Practice Address - Street 1:2700 5TH AVE. S.
Practice Address - Street 2:DOCTORS PARK #204
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-9829
Practice Address - Country:US
Practice Address - Phone:906-786-3159
Practice Address - Fax:906-786-2952
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0147841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice