Provider Demographics
NPI:1073126322
Name:LEVEILLE, PAUL DANIEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DANIEL
Last Name:LEVEILLE
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 1:1395 CENTER DR RM D1-17
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-3504
Mailing Address - Country:US
Mailing Address - Phone:352-273-5440
Mailing Address - Fax:352-273-5446
Practice Address - Street 1:1395 CENTER DR RM D1-17
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3504
Practice Address - Country:US
Practice Address - Phone:352-273-5440
Practice Address - Fax:352-273-5446
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002044651223G0001X
FLDRPM24401223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223G0001XDental ProvidersDentistGeneral Practice