Provider Demographics
NPI:1700048097
Name:ROMANO, PAUL ALFRED (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ALFRED
Last Name:ROMANO
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 1:728 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-2703
Mailing Address - Country:US
Mailing Address - Phone:570-523-3991
Mailing Address - Fax:
Practice Address - Street 1:728 MARKET ST
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-2703
Practice Address - Country:US
Practice Address - Phone:570-523-3991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS036203122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist