Provider Demographics
NPI:1821008756
Name:PASCHAL, JAMES E JR (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:PASCHAL
Suffix:JR
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:153 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:GA
Mailing Address - Zip Code:30650-1218
Mailing Address - Country:US
Mailing Address - Phone:706-342-7330
Mailing Address - Fax:678-559-0756
Practice Address - Street 1:153 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:GA
Practice Address - Zip Code:30650-1218
Practice Address - Country:US
Practice Address - Phone:706-342-7330
Practice Address - Fax:678-559-0756
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0112131223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics