Provider Demographics
NPI:1811295686
Name:CHAD PERRY LPPC
Entity type:Organization
Organization Name:CHAD PERRY LPPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:C
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-812-2082
Mailing Address - Street 1:8408 DAVIS BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:N RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-8685
Mailing Address - Country:US
Mailing Address - Phone:817-812-2082
Mailing Address - Fax:
Practice Address - Street 1:8408 DAVIS BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:N RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-8685
Practice Address - Country:US
Practice Address - Phone:817-812-2082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21037122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty