Provider Demographics
NPI:1366648289
Name:PAUL C. KAZMER, JR.,DMD,MS,PA
Entity Type:Organization
Organization Name:PAUL C. KAZMER, JR.,DMD,MS,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:CHESTER
Authorized Official - Last Name:KAZMER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD,MSPA
Authorized Official - Phone:919-468-6410
Mailing Address - Street 1:130 PRESTON EXECUTIVE DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-8433
Mailing Address - Country:US
Mailing Address - Phone:919-468-6410
Mailing Address - Fax:919-468-4314
Practice Address - Street 1:130 PRESTON EXECUTIVE DR
Practice Address - Street 2:SUITE 204
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8433
Practice Address - Country:US
Practice Address - Phone:919-468-6410
Practice Address - Fax:919-468-4314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC65781223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty