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1629642079
ETHAN HARRISON PERELLIS
LOUISVILLE, KY
NPI
1629642079
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: KY 10582)
Enumeration Date
2021-05-19
Last Update Date
2021-05-19
Business Address
Dr. ETHAN HARRISON PERELLIS DMD
9451 WESTPORT RD STE 109
LOUISVILLE, KY 40241-2295
Phone number: 502-412-5900
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Mailing Address
Dr. ETHAN HARRISON PERELLIS DMD
9451 WESTPORT RD STE 109
LOUISVILLE, KY 40241-2295
Phone number: 502-412-5900
Copy
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