Provider Demographics
NPI:1760141345
Name:PERRY, HEATHER MORGAN (DDS)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:MORGAN
Last Name:PERRY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 ASH ST
Mailing Address - Street 2:
Mailing Address - City:SUSANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96130-3716
Mailing Address - Country:US
Mailing Address - Phone:530-257-7256
Mailing Address - Fax:
Practice Address - Street 1:720 ASH ST
Practice Address - Street 2:
Practice Address - City:SUSANVILLE
Practice Address - State:CA
Practice Address - Zip Code:96130-3716
Practice Address - Country:US
Practice Address - Phone:530-257-7256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-10
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1069171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice