Provider Demographics
NPI:1255482048
Name:DAVID W. PAULUSSEN, D.M.D.PA
Entity Type:Organization
Organization Name:DAVID W. PAULUSSEN, D.M.D.PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:H
Authorized Official - Last Name:PAULUSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-850-4200
Mailing Address - Street 1:354 US HIGHWAY 46 W
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-5335
Mailing Address - Country:US
Mailing Address - Phone:908-850-4200
Mailing Address - Fax:908-850-3730
Practice Address - Street 1:354 US HIGHWAY 46 W
Practice Address - Street 2:SUITE 1A
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-5335
Practice Address - Country:US
Practice Address - Phone:908-850-4200
Practice Address - Fax:908-850-3730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ151791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty