Provider Demographics
NPI:1598302705
Name:PAUL F ECKSTEIN DMD PA
Entity Type:Organization
Organization Name:PAUL F ECKSTEIN DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:F
Authorized Official - Last Name:ECKSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD PA
Authorized Official - Phone:727-319-6019
Mailing Address - Street 1:6019 SEMINOLE BLVD
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-7336
Mailing Address - Country:US
Mailing Address - Phone:727-319-6019
Mailing Address - Fax:727-398-6019
Practice Address - Street 1:6019 SEMINOLE BLVD
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-7336
Practice Address - Country:US
Practice Address - Phone:727-319-6019
Practice Address - Fax:727-398-6019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-06
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty