Provider Demographics
NPI:1225243199
Name:SLUSARZ, PAUL DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DAVID
Last Name:SLUSARZ
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 1:799 WILBUR AVE
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-2143
Mailing Address - Country:US
Mailing Address - Phone:508-678-4851
Mailing Address - Fax:
Practice Address - Street 1:799 WILBUR AVE
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-2143
Practice Address - Country:US
Practice Address - Phone:508-678-4851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA209891223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics