Provider Demographics
NPI:1932622701
Name:PERIMENIS, RORY J (DDS)
Entity Type:Individual
Prefix:DR
First Name:RORY
Middle Name:J
Last Name:PERIMENIS
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 1:324 ELM ST STE 201A
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-2282
Mailing Address - Country:US
Mailing Address - Phone:203-459-8990
Mailing Address - Fax:203-261-3187
Practice Address - Street 1:324 ELM ST STE 201A
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468-2282
Practice Address - Country:US
Practice Address - Phone:203-459-8990
Practice Address - Fax:203-261-3187
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11848122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist