Provider Demographics
NPI:1902026594
Name:NOGUEIRA, PAULO J (DMD,MSD)
Entity Type:Individual
Prefix:DR
First Name:PAULO
Middle Name:J
Last Name:NOGUEIRA
Suffix:
Gender:M
Credentials:DMD,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02762-2641
Mailing Address - Country:US
Mailing Address - Phone:508-695-2064
Mailing Address - Fax:508-695-8492
Practice Address - Street 1:16 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:MA
Practice Address - Zip Code:02762-2641
Practice Address - Country:US
Practice Address - Phone:508-695-2064
Practice Address - Fax:508-695-8492
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA192171223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics