Provider Demographics
NPI:1043351620
Name:TEPLITSKY, PAUL W (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:W
Last Name:TEPLITSKY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:339 HICKS ST
Mailing Address - Street 2:LICH DEPARTMENT OF DENTISTRY
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5509
Mailing Address - Country:US
Mailing Address - Phone:718-780-4630
Mailing Address - Fax:718-780-2981
Practice Address - Street 1:339 HICKS ST
Practice Address - Street 2:LICH DEPARTMENT OF DENTISTRY
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5509
Practice Address - Country:US
Practice Address - Phone:718-780-4630
Practice Address - Fax:718-780-2981
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0358191223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics