Provider Demographics
NPI:1912914730
Name:PERKINS, JAMES PAUL (DMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PAUL
Last Name:PERKINS
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 1:206 MAIN ST
Mailing Address - Street 2:P.O. BOX 68
Mailing Address - City:GLEASON
Mailing Address - State:TN
Mailing Address - Zip Code:38229-7270
Mailing Address - Country:US
Mailing Address - Phone:731-648-9000
Mailing Address - Fax:
Practice Address - Street 1:206 MAIN ST
Practice Address - Street 2:
Practice Address - City:GLEASON
Practice Address - State:TN
Practice Address - Zip Code:38229-7270
Practice Address - Country:US
Practice Address - Phone:731-648-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS38511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice