Provider Demographics
NPI:1346360740
Name:MACDONALD, PAUL EDWIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:EDWIN
Last Name:MACDONALD
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 1:132 CENTRAL ST
Mailing Address - Street 2:UNIT #103
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2433
Mailing Address - Country:US
Mailing Address - Phone:508-668-2276
Mailing Address - Fax:508-543-3147
Practice Address - Street 1:132 CENTRAL ST
Practice Address - Street 2:UNIT #103
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2433
Practice Address - Country:US
Practice Address - Phone:508-668-2276
Practice Address - Fax:508-543-3147
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA114921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice