Provider Demographics
NPI:1821115643
Name:TROMBLY, PAUL LEWIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:LEWIS
Last Name:TROMBLY
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 1:225 FAIRVIEW LN
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:RI
Mailing Address - Zip Code:02871-3826
Mailing Address - Country:US
Mailing Address - Phone:401-862-2713
Mailing Address - Fax:
Practice Address - Street 1:225 FAIRVIEW LN
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871-3826
Practice Address - Country:US
Practice Address - Phone:401-862-2713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN026471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice