Provider Demographics
NPI:1902287485
Name:CHRISTOPHER S. PERRIE, DDS, MD, LLC
Entity Type:Organization
Organization Name:CHRISTOPHER S. PERRIE, DDS, MD, LLC
Other - Org Name:ARDMORE ORAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRIE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:215-528-3439
Mailing Address - Street 1:32 PARKING PLZ
Mailing Address - Street 2:SUITE 502
Mailing Address - City:ARDMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19003-2415
Mailing Address - Country:US
Mailing Address - Phone:215-528-3439
Mailing Address - Fax:
Practice Address - Street 1:32 PARKING PLZ
Practice Address - Street 2:SUITE 502
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2415
Practice Address - Country:US
Practice Address - Phone:215-528-3439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037460261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery