1740535566 NPI number — DR. SETH LOUNSBURY PERRINS D.D.S.

Table of content: DR. SETH LOUNSBURY PERRINS D.D.S. (NPI 1740535566)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740535566 NPI number — DR. SETH LOUNSBURY PERRINS D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PERRINS
Provider First Name:
SETH
Provider Middle Name:
LOUNSBURY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.D.S.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740535566
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
EVANS DENTAL CLINIC CAMP FOSTER
Provider Second Line Business Mailing Address:
BLDG. 5717 ON TARAWA ST.
Provider Business Mailing Address City Name:
FPO
Provider Business Mailing Address State Name:
AP
Provider Business Mailing Address Postal Code:
47211
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CAMP FOSTER POST OFFICE
Provider Second Line Business Practice Location Address:
BLDG. 5717
Provider Business Practice Location Address City Name:
FPO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96379
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
98-645-7381
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/18/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  60294726 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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