Provider Demographics
NPI:1770950859
Name:ACCENT PERMANENT MAKEUP STUDIO,LLC
Entity type:Organization
Organization Name:ACCENT PERMANENT MAKEUP STUDIO,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ARTIST
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:PERCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-528-1309
Mailing Address - Street 1:43343 CORTE RIALTO
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-3059
Mailing Address - Country:US
Mailing Address - Phone:909-528-1309
Mailing Address - Fax:951-695-7770
Practice Address - Street 1:29377 RANCHO CALIFORNIA RD
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5289
Practice Address - Country:US
Practice Address - Phone:909-528-1309
Practice Address - Fax:951-695-7770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-25
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Multi-Specialty
No305S00000XManaged Care OrganizationsPoint of ServiceGroup - Multi-Specialty