Provider Demographics
NPI:1508824590
Name:WINBORN, PAUL L II (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:L
Last Name:WINBORN
Suffix:II
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1501 S WALDRON RD
Mailing Address - Street 2:ST. 208
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-2574
Mailing Address - Country:US
Mailing Address - Phone:479-478-9955
Mailing Address - Fax:479-478-6632
Practice Address - Street 1:1501 S WALDRON RD
Practice Address - Street 2:ST. 208
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-2574
Practice Address - Country:US
Practice Address - Phone:479-478-9955
Practice Address - Fax:479-478-6632
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AR32951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice