Provider Demographics
NPI:1225297468
Name:MENGES, PAUL BAKER (DDS)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:BAKER
Last Name:MENGES
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 1:2581 NUT TREE RD STE A
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-6915
Mailing Address - Country:US
Mailing Address - Phone:707-448-9211
Mailing Address - Fax:707-448-0244
Practice Address - Street 1:2581 NUT TREE RD STE A
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-6915
Practice Address - Country:US
Practice Address - Phone:707-448-9211
Practice Address - Fax:707-448-0244
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA168051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice