Individual
THALIA-RAE PERRYMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1625 SE 192ND AVE # 205, CAMAS, WA 98607-7441
(360) 835-6001
(360) 835-6002
Mailing address
1625 SE 192ND AVE STE 205, CAMAS, WA 98607-6505
(360) 835-6001
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11463
OR
Other
Enumeration date
06/11/2015
Last updated
05/02/2024
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