Organization
PRENTISS A. PERKINS, D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETSY ST. ANN (SECRETARY)
(337) 468-2787
Entity
Organization
Contact information
Practice address
908 6TH ST, MAMOU, LA 70554-3122
(337) 468-2787
(337) 468-2797
Mailing address
908 6TH ST, MAMOU, LA 70554-3122
(337) 468-2787
(337) 468-2797
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3999
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31337
—
LA
05
—
6659
—
LA
Enumeration date
06/30/2016
Last updated
06/30/2016
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