Provider Demographics
NPI:1992145932
Name:PERRY, ALLISON KATELYN (DMD)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:KATELYN
Last Name:PERRY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2028 AVIGNON PL
Mailing Address - Street 2:
Mailing Address - City:HALF MOON BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94019-1431
Mailing Address - Country:US
Mailing Address - Phone:650-867-6005
Mailing Address - Fax:
Practice Address - Street 1:1828 EL CAMINO REAL STE 810
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3124
Practice Address - Country:US
Practice Address - Phone:650-692-0727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62511122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist