Provider Demographics
NPI:1538272950
Name:PERPICH, ROSALIE J (DDS, PA)
Entity type:Individual
Prefix:MRS
First Name:ROSALIE
Middle Name:J
Last Name:PERPICH
Suffix:
Gender:F
Credentials:DDS, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 TOWER DR W STE 130
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-7585
Mailing Address - Country:US
Mailing Address - Phone:651-351-0890
Mailing Address - Fax:651-351-1922
Practice Address - Street 1:1725 TOWER DR W STE 130
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-7585
Practice Address - Country:US
Practice Address - Phone:651-351-0890
Practice Address - Fax:651-351-1922
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN111961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice