Provider Demographics
NPI:1609119346
Name:POINT PLACE FAMILY DENTISTRY PAUL VESOULIS DDS
Entity Type:Organization
Organization Name:POINT PLACE FAMILY DENTISTRY PAUL VESOULIS DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:VESOULIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-729-3972
Mailing Address - Street 1:4611 N SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43611-2812
Mailing Address - Country:US
Mailing Address - Phone:419-729-3972
Mailing Address - Fax:419-729-3938
Practice Address - Street 1:4611 N SUMMIT ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43611-2812
Practice Address - Country:US
Practice Address - Phone:419-729-3972
Practice Address - Fax:419-729-3938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH18293122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty