Provider Demographics
NPI:1386667004
Name:PERKINS, LARRY F (DDS, PA)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:F
Last Name:PERKINS
Suffix:
Gender:M
Credentials:DDS, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5922 WEDDINGTON MONROE RD
Mailing Address - Street 2:SUITE A-2
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:NC
Mailing Address - Zip Code:28104-8202
Mailing Address - Country:US
Mailing Address - Phone:704-843-5757
Mailing Address - Fax:704-843-5041
Practice Address - Street 1:5922 WEDDINGTON MONROE RD
Practice Address - Street 2:SUITE A-2
Practice Address - City:WESLEY CHAPEL
Practice Address - State:NC
Practice Address - Zip Code:28104-8202
Practice Address - Country:US
Practice Address - Phone:704-843-5757
Practice Address - Fax:704-843-5041
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC63711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice