Provider Demographics
NPI:1982727343
Name:PERELMUTER, BRIAN NEAL (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:NEAL
Last Name:PERELMUTER
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 1:156 MEADOW ST
Mailing Address - Street 2:
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-4037
Mailing Address - Country:US
Mailing Address - Phone:203-729-3323
Mailing Address - Fax:203-720-1094
Practice Address - Street 1:156 MEADOW ST
Practice Address - Street 2:
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-4037
Practice Address - Country:US
Practice Address - Phone:203-729-3323
Practice Address - Fax:203-720-1094
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT94901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice