Provider Demographics
NPI:1295823607
Name:PAFFORD, PAUL EDWARD (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:EDWARD
Last Name:PAFFORD
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 1:131 LANGLEY DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-6909
Mailing Address - Country:US
Mailing Address - Phone:770-963-4999
Mailing Address - Fax:770-822-4883
Practice Address - Street 1:131 LANGLEY DR
Practice Address - Street 2:SUITE D
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-6909
Practice Address - Country:US
Practice Address - Phone:770-963-4999
Practice Address - Fax:770-822-4883
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN008620122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist