Provider Demographics
NPI:1366506412
Name:DAVIN, PAUL DAVID (DDS)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:DAVID
Last Name:DAVIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 SEARS RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MA
Mailing Address - Zip Code:02493-1621
Mailing Address - Country:US
Mailing Address - Phone:781-893-6393
Mailing Address - Fax:
Practice Address - Street 1:68 TRAPELO RD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-4447
Practice Address - Country:US
Practice Address - Phone:617-484-6622
Practice Address - Fax:617-484-1275
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA153901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice