Provider Demographics
NPI:1962584268
Name:PERRIN, JOHN H (DMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:PERRIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4765 HODGES BLVD
Mailing Address - Street 2:STE. 5
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-5280
Mailing Address - Country:US
Mailing Address - Phone:904-992-9396
Mailing Address - Fax:904-992-1163
Practice Address - Street 1:4765 HODGES BLVD
Practice Address - Street 2:STE. 5
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-5280
Practice Address - Country:US
Practice Address - Phone:904-992-9396
Practice Address - Fax:904-992-1163
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0140451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice