Provider Demographics
NPI:1558552489
Name:DR STEPHEN C PAUL
Entity Type:Organization
Organization Name:DR STEPHEN C PAUL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-852-8919
Mailing Address - Street 1:20 PENN PLZ
Mailing Address - Street 2:SUITE 31
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3620
Mailing Address - Country:US
Mailing Address - Phone:207-942-8894
Mailing Address - Fax:207-990-4838
Practice Address - Street 1:20 PENN PLZ
Practice Address - Street 2:SUITE 31
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3620
Practice Address - Country:US
Practice Address - Phone:207-942-8894
Practice Address - Fax:207-990-4838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME33221223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty