Provider Demographics
NPI:1639290547
Name:PAULISON DENTAL CARE D.D.S, P.C.
Entity Type:Organization
Organization Name:PAULISON DENTAL CARE D.D.S, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ROSANNA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:HILARIO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-778-7272
Mailing Address - Street 1:244 PAULISON AVE
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-3806
Mailing Address - Country:US
Mailing Address - Phone:973-778-7272
Mailing Address - Fax:
Practice Address - Street 1:244 PAULISON AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-3806
Practice Address - Country:US
Practice Address - Phone:973-778-7272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI206271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8366209Medicaid
NJ8366209Medicaid