Provider Demographics
NPI:1699807073
Name:KING, PAIGE (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAIGE
Middle Name:
Last Name:KING
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 1:1102 GENERAL SULLIVAN DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-8096
Mailing Address - Country:US
Mailing Address - Phone:619-793-0957
Mailing Address - Fax:
Practice Address - Street 1:1805 FOULK RD
Practice Address - Street 2:SUITE D
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-3700
Practice Address - Country:US
Practice Address - Phone:302-475-3270
Practice Address - Fax:302-475-3259
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1066122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist