Mark Duane Perry
Dentist, General Practice in New Boston, TX. Organization (NPI-2).
NPI number1245500099
StatusActive
Last updated in NPPESJan 11, 2012
Details
- NPI
- 1245500099
- Entity type
- Organization (NPI-2)
- Legal business name
- Mark Duane Perry
- Organization subpart
- No
- Enumeration date
- Jan 11, 2012
- Last updated
- Jan 11, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 16865 | TX | Yes |
Practice location
104 Tyson StNew Boston, TX 75570-2820
Phone 903-628-3312 · Fax 903-628-5631
Mailing address
104 TysonNew Boston, TX 75570-2028
Phone 903-628-3312 · Fax 903-628-5631
Authorized official
Mark Duane Perry
Doctor
9036283312
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