Provider Demographics
NPI:1659376481
Name:LEVINE, PAUL DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DAVID
Last Name:LEVINE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13111 WESTHEIMER RD
Mailing Address - Street 2:STE 250
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-5520
Mailing Address - Country:US
Mailing Address - Phone:281-759-2626
Mailing Address - Fax:281-759-2634
Practice Address - Street 1:13111 WESTHEIMER RD
Practice Address - Street 2:STE 250
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-5520
Practice Address - Country:US
Practice Address - Phone:281-759-2626
Practice Address - Fax:281-759-2634
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX134761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX678927OtherUNITED CONCORDIA