Provider Demographics
NPI:1689705303
Name:PAULI, EMIL ALFRED (DMD)
Entity Type:Individual
Prefix:DR
First Name:EMIL
Middle Name:ALFRED
Last Name:PAULI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ATHOL
Mailing Address - State:MA
Mailing Address - Zip Code:01331-2633
Mailing Address - Country:US
Mailing Address - Phone:978-249-7998
Mailing Address - Fax:978-249-9701
Practice Address - Street 1:1528 MAIN ST
Practice Address - Street 2:
Practice Address - City:ATHOL
Practice Address - State:MA
Practice Address - Zip Code:01331-2633
Practice Address - Country:US
Practice Address - Phone:978-249-7998
Practice Address - Fax:978-249-9701
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA139071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice