Provider Demographics
NPI:1518960129
Name:FEILD, PAUL E (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:E
Last Name:FEILD
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 1:12619 HARFORD ROAD
Mailing Address - Street 2:P.O. BOX 530
Mailing Address - City:FORK
Mailing Address - State:MD
Mailing Address - Zip Code:21051-0530
Mailing Address - Country:US
Mailing Address - Phone:410-592-5420
Mailing Address - Fax:410-592-5457
Practice Address - Street 1:12619 HARFORD ROAD
Practice Address - Street 2:
Practice Address - City:FORK
Practice Address - State:MD
Practice Address - Zip Code:21051-0530
Practice Address - Country:US
Practice Address - Phone:410-592-5420
Practice Address - Fax:410-592-5457
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD82751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2574OtherMARYLAND DENTAL PLAN
MD070NMedicare ID - Type Unspecified