Provider Demographics
NPI:1346401452
Name:NOLAND, PAUL BROOKS (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:BROOKS
Last Name:NOLAND
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 1:3011 SW NOTTINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-1610
Mailing Address - Country:US
Mailing Address - Phone:503-789-8465
Mailing Address - Fax:
Practice Address - Street 1:12400 SW ALLEN BLVD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-4714
Practice Address - Country:US
Practice Address - Phone:503-644-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR90921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice