Provider Demographics
NPI:1316664709
Name:LUIS A PEREZ DDS MS PC
Entity type:Organization
Organization Name:LUIS A PEREZ DDS MS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS PC
Authorized Official - Phone:810-230-1311
Mailing Address - Street 1:2222 S LINDEN RD STE D
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-5413
Mailing Address - Country:US
Mailing Address - Phone:810-230-1311
Mailing Address - Fax:
Practice Address - Street 1:2222 S LINDEN RD STE D
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-5413
Practice Address - Country:US
Practice Address - Phone:810-230-1311
Practice Address - Fax:810-230-1314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty