Provider Demographics
NPI:1588878318
Name:PEREL, MORTON L (DDS)
Entity type:Individual
Prefix:DR
First Name:MORTON
Middle Name:L
Last Name:PEREL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 WAYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4316
Mailing Address - Country:US
Mailing Address - Phone:401-861-1343
Mailing Address - Fax:401-453-1343
Practice Address - Street 1:116 WAYLAND AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4316
Practice Address - Country:US
Practice Address - Phone:401-861-1343
Practice Address - Fax:401-453-1343
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN015331223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics