Provider Demographics
NPI:1033125141
Name:SCHUBERT, PAUL MOSE (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MOSE
Last Name:SCHUBERT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 DEVONIA ST
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-2010
Mailing Address - Country:US
Mailing Address - Phone:865-882-0900
Mailing Address - Fax:865-882-7409
Practice Address - Street 1:421 DEVONIA ST
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748-2010
Practice Address - Country:US
Practice Address - Phone:865-882-0900
Practice Address - Fax:865-882-7409
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice