Provider Demographics
NPI:1841413671
Name:PAUL C. KUO, M.D., D.M.D., P.C.
Entity Type:Organization
Organization Name:PAUL C. KUO, M.D., D.M.D., P.C.
Other - Org Name:CENTER FOR COSMETIC FACIAL AND ORAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:C
Authorized Official - Last Name:KUO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DMD
Authorized Official - Phone:617-566-8800
Mailing Address - Street 1:405 COCHITUATE RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-4648
Mailing Address - Country:US
Mailing Address - Phone:508-424-2525
Mailing Address - Fax:508-424-2528
Practice Address - Street 1:209 HARVARD ST
Practice Address - Street 2:SUITE 405
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5005
Practice Address - Country:US
Practice Address - Phone:617-566-8800
Practice Address - Fax:617-566-8818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA134871223S0112X
NH10451204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
Not Answered204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Multi-Specialty