Provider Demographics
NPI:1437290731
Name:PAUL F MASTERSON DDS PA
Entity Type:Organization
Organization Name:PAUL F MASTERSON DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:F
Authorized Official - Last Name:MASTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:603-893-4538
Mailing Address - Street 1:32 STILES RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2892
Mailing Address - Country:US
Mailing Address - Phone:603-893-4538
Mailing Address - Fax:603-893-9970
Practice Address - Street 1:32 STILES RD
Practice Address - Street 2:SUITE 205
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2892
Practice Address - Country:US
Practice Address - Phone:603-893-4538
Practice Address - Fax:603-893-9970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1274122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH89191684Medicaid