Provider Demographics
NPI:1780722843
Name:PERFETTI, PAUL JOHN (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JOHN
Last Name:PERFETTI
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 1:595 WOODBURY RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1005
Mailing Address - Country:US
Mailing Address - Phone:516-938-3522
Mailing Address - Fax:516-931-6105
Practice Address - Street 1:595 WOODBURY RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1005
Practice Address - Country:US
Practice Address - Phone:516-938-3522
Practice Address - Fax:516-931-6105
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0406311223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics