Provider Demographics
NPI:1629237748
Name:ARCHACKI, PAUL VICTOR (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:VICTOR
Last Name:ARCHACKI
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 1:639 E OCEAN AVE SUITE 104
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435
Mailing Address - Country:US
Mailing Address - Phone:561-736-1177
Mailing Address - Fax:561-736-1283
Practice Address - Street 1:639 E OCEAN AVE SUITE 104
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435
Practice Address - Country:US
Practice Address - Phone:561-736-1177
Practice Address - Fax:561-736-1283
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL83751223P0700X
FLAA95993971223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics