Perry Dental, LTD
Organization Active NPI General Practice Dentistry · Eyota, MN
NPI 1417469198 · NPPES record last updated Nov 2, 2017
Key facts
- NPI
- 1417469198
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D12826 (MN)
- Legal business name
- PERRY DENTAL, LTD
- Practice address
- 515 Jefferson Ave S.W.
Eyota, MN 55934 - Phone
- (507) 585-5200
- Fax
- (507) 585-5202
- NPI assigned
- Nov 2, 2017
- Organization subpart
- Yes
- Parent organization (as reported)
- PERRY DENTAL, LTD
Authorized official
- Name
- Mr. Joseph Thomas Line, D.D.S.
- Title
- Dentist
- Phone
- (507) 585-5200
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Perry Dental LTD
- Part of
- Perry Dental LTD
Locations
515 Jefferson Ave SW
Eyota, MN 55934
Phone (507) 585-5200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | D12826 | MN | Yes |
Addresses
Primary practice location
515 Jefferson Ave S.W.
Eyota, MN 55934
Mailing address
515 Jefferson Ave S.W.
Eyota, MN 55934
Phone (507) 585-5200
Other providers in Eyota, MN
- City of Eyota
- Madisyn Collins-Simones
- Dover-Eyota 533
- Eyota Volunteer Ambulance Service
- Elizabeth Littlefield
- Premier Chiropractic LLC
- Mary Kay Sharp Piltingsrud
- Cynthia Tri
- Mark Westphal
All providers in Eyota, MN · General Practice Dentistry in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.