Provider Demographics
NPI:1639506157
Name:PAUL J GASKINS DDS PA
Entity Type:Organization
Organization Name:PAUL J GASKINS DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:GASKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:252-903-6250
Mailing Address - Street 1:7958 BRIAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27803-8525
Mailing Address - Country:US
Mailing Address - Phone:252-903-6250
Mailing Address - Fax:252-977-9031
Practice Address - Street 1:7958 BRIAR CREEK RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27803-8525
Practice Address - Country:US
Practice Address - Phone:252-903-6250
Practice Address - Fax:252-977-9031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-29
Last Update Date:2022-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC79801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC133208OtherNC DENTAL BOARD PA CERTIFICATION