Provider Demographics
NPI:1942427323
Name:PEREZ, DAVID ROY (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROY
Last Name:PEREZ
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 1:4300 N UNIVERSITY DRIVE
Mailing Address - Street 2:#D-207
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33351-4840
Mailing Address - Country:US
Mailing Address - Phone:954-533-9867
Mailing Address - Fax:954-533-9867
Practice Address - Street 1:4300 N UNIVERSITY DRIVE
Practice Address - Street 2:#D-207
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351
Practice Address - Country:US
Practice Address - Phone:954-533-9867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN121101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDN12110OtherDENTAL LICENCE
FL650987643OtherTAX ID