Provider Demographics
NPI:1043295108
Name:NIOSI, PAUL FRANCIS (DMD)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:FRANCIS
Last Name:NIOSI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1595 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-1694
Mailing Address - Country:US
Mailing Address - Phone:781-344-1505
Mailing Address - Fax:781-341-2677
Practice Address - Street 1:1595 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-1694
Practice Address - Country:US
Practice Address - Phone:781-344-1505
Practice Address - Fax:781-341-2677
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11045122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0227382Medicaid
T90256Medicare UPIN