Provider Demographics
NPI:1770507782
Name:PAOLELLA, STEPHEN JOSEPH (DMD,MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JOSEPH
Last Name:PAOLELLA
Suffix:
Gender:M
Credentials:DMD,MD
Other - Prefix:
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Mailing Address - Street 1:53 SOUTHAMPTON RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-1582
Mailing Address - Country:US
Mailing Address - Phone:413-562-1100
Mailing Address - Fax:413-562-3653
Practice Address - Street 1:53 SOUTHAMPTON RD
Practice Address - Street 2:SUITE 5
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-1582
Practice Address - Country:US
Practice Address - Phone:413-562-1100
Practice Address - Fax:413-562-3653
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA197091223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAX08683OtherBCBS
H85985Medicare UPIN
MAX08683OtherBCBS