Provider Demographics
NPI:1114945367
Name:STUBBS, PAUL COLEMAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:COLEMAN
Last Name:STUBBS
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 1:300 TAZEWELL ST
Mailing Address - Street 2:P.O. BOX F
Mailing Address - City:PEARISBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24134-1730
Mailing Address - Country:US
Mailing Address - Phone:540-921-3323
Mailing Address - Fax:
Practice Address - Street 1:300 TAZEWELL ST
Practice Address - Street 2:
Practice Address - City:PEARISBURG
Practice Address - State:VA
Practice Address - Zip Code:24134-1730
Practice Address - Country:US
Practice Address - Phone:540-921-3323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010069171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice