Provider Demographics
NPI:1316382575
Name:PAUL, BIJU E (DMD)
Entity Type:Individual
Prefix:
First Name:BIJU
Middle Name:E
Last Name:PAUL
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:PO BOX 464
Mailing Address - Street 2:
Mailing Address - City:UWCHLAND
Mailing Address - State:PA
Mailing Address - Zip Code:19480-0464
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:207 PARK RD
Practice Address - Street 2:
Practice Address - City:UWCHLAND
Practice Address - State:PA
Practice Address - Zip Code:19480
Practice Address - Country:US
Practice Address - Phone:610-458-1178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-01
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS039541122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist