Provider Demographics
NPI:1902940695
Name:PERRY, DONALD C (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:C
Last Name:PERRY
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 1:601 SHORE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-2530
Mailing Address - Country:US
Mailing Address - Phone:609-641-2700
Mailing Address - Fax:609-641-5275
Practice Address - Street 1:601 SHORE RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-2530
Practice Address - Country:US
Practice Address - Phone:609-641-2700
Practice Address - Fax:609-641-5275
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI007038001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice