Provider Demographics
NPI:1336143858
Name:SCULL, PAUL J (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:J
Last Name:SCULL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:575 BOYLSTON ST.
Mailing Address - Street 2:5TH FLOOR RIGHT
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-3607
Mailing Address - Country:US
Mailing Address - Phone:617-536-6668
Mailing Address - Fax:617-267-2331
Practice Address - Street 1:575 BOYLSTON ST.
Practice Address - Street 2:5TH FLOOR RIGHT
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-3607
Practice Address - Country:US
Practice Address - Phone:617-536-6668
Practice Address - Fax:617-267-2331
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA208531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice