Provider Demographics
NPI:1164598926
Name:DIMAGGIO, PAUL JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JOSEPH
Last Name:DIMAGGIO
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 1:1757 E BASELINE RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-1532
Mailing Address - Country:US
Mailing Address - Phone:480-892-8199
Mailing Address - Fax:480-892-8291
Practice Address - Street 1:1757 E BASELINE RD
Practice Address - Street 2:SUITE 109
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-1532
Practice Address - Country:US
Practice Address - Phone:480-892-8199
Practice Address - Fax:480-892-8291
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice