Provider Demographics
NPI:1679628937
Name:DOOLEY, PAUL J (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:J
Last Name:DOOLEY
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 1:708 STEINHAGEN RD
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63383-1115
Mailing Address - Country:US
Mailing Address - Phone:636-456-3362
Mailing Address - Fax:636-456-3362
Practice Address - Street 1:708 STEINHAGEN RD
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:MO
Practice Address - Zip Code:63383-1115
Practice Address - Country:US
Practice Address - Phone:636-456-3362
Practice Address - Fax:636-456-3362
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO13462122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist