Provider Demographics
NPI:1427722933
Name:ADRIANA S PEREZ DMD INC.
Entity type:Organization
Organization Name:ADRIANA S PEREZ DMD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIANA
Authorized Official - Middle Name:S
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:909-815-1715
Mailing Address - Street 1:80 W GRAND BLVD STE 111
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-2059
Mailing Address - Country:US
Mailing Address - Phone:951-549-1111
Mailing Address - Fax:951-549-1190
Practice Address - Street 1:80 W GRAND BLVD STE 111
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-2059
Practice Address - Country:US
Practice Address - Phone:951-549-1111
Practice Address - Fax:951-549-1190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-07
Last Update Date:2021-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty