Organization
DR. DAVID H. PERELLIS, DMD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID HARRISON PERELLIS (DENTIST/OWNER)
(502) 412-5900
Entity
Organization
Contact information
Practice address
9467 WESTPORT RD, LOUISVILLE, KY 40241-2219
(502) 412-5900
Mailing address
9467 WESTPORT RD, LOUISVILLE, KY 40241-2219
(502) 412-5900
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6180
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60061801
—
KY
Enumeration date
04/03/2008
Last updated
04/03/2008
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