Provider Demographics
NPI:1841405263
Name:PAULSON, ERIC G (DDS)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:G
Last Name:PAULSON
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 1:9000 GLACIER HWY
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-8032
Mailing Address - Country:US
Mailing Address - Phone:907-789-5008
Mailing Address - Fax:907-789-1057
Practice Address - Street 1:9000 GLACIER HWY
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-8032
Practice Address - Country:US
Practice Address - Phone:907-789-5008
Practice Address - Fax:907-789-1057
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK595122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist