Provider Demographics
NPI:1144249780
Name:PERROTTI, STEVEN DAVID (DMD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:DAVID
Last Name:PERROTTI
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 1:6305 GAGE PL APT 102-A
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2323
Mailing Address - Country:US
Mailing Address - Phone:305-557-4262
Mailing Address - Fax:
Practice Address - Street 1:2375 SW 27 AVENUE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145
Practice Address - Country:US
Practice Address - Phone:305-856-2300
Practice Address - Fax:305-856-0921
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15477122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist