Provider Demographics
NPI:1114138617
Name:PEREZ, RAMON A (DMD)
Entity type:Individual
Prefix:
First Name:RAMON
Middle Name:A
Last Name:PEREZ
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 1:15661 SHERIDAN ST STE C4
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3497
Mailing Address - Country:US
Mailing Address - Phone:954-693-0026
Mailing Address - Fax:954-693-0085
Practice Address - Street 1:15661 SHERIDAN ST STE C4
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33331-3497
Practice Address - Country:US
Practice Address - Phone:954-693-0026
Practice Address - Fax:954-693-0085
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN162031223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery