Provider Demographics
NPI:1003905902
Name:PONTE, PAUL M (DDS, MSCD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:M
Last Name:PONTE
Suffix:
Gender:M
Credentials:DDS, MSCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1379 TUCKER RD
Mailing Address - Street 2:
Mailing Address - City:NORTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-3152
Mailing Address - Country:US
Mailing Address - Phone:508-996-3133
Mailing Address - Fax:508-996-3134
Practice Address - Street 1:1379 TUCKER RD
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-3152
Practice Address - Country:US
Practice Address - Phone:508-996-3133
Practice Address - Fax:508-996-3134
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA116801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice