Provider Demographics
NPI:1235303843
Name:KRAINSON, PAUL MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MICHAEL
Last Name:KRAINSON
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 1:4740 CONNECTICUT AVE NW
Mailing Address - Street 2:#102
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-5628
Mailing Address - Country:US
Mailing Address - Phone:202-537-0003
Mailing Address - Fax:202-364-3294
Practice Address - Street 1:4740 CONNECTICUT AVE NW
Practice Address - Street 2:#102
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-5628
Practice Address - Country:US
Practice Address - Phone:202-537-0003
Practice Address - Fax:202-364-3294
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC29321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice