Provider Demographics
NPI:1811030125
Name:ROBERTS, PAUL STEVEN (DDS)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:STEVEN
Last Name:ROBERTS
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 1:490 A MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-6304
Mailing Address - Country:US
Mailing Address - Phone:914-632-8744
Mailing Address - Fax:914-632-8799
Practice Address - Street 1:490 A MAIN STREET
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-6304
Practice Address - Country:US
Practice Address - Phone:914-632-8744
Practice Address - Fax:914-632-8799
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032609122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist