Provider Demographics
NPI:1952469488
Name:KINSEY, PAUL J (DDS)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:KINSEY
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 1:515 BENFIELD ROAD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-2519
Mailing Address - Country:US
Mailing Address - Phone:410-544-4012
Mailing Address - Fax:410-544-4019
Practice Address - Street 1:515 BENFIELD ROAD
Practice Address - Street 2:SUITE 202
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-2519
Practice Address - Country:US
Practice Address - Phone:410-544-4012
Practice Address - Fax:410-544-4019
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD94671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD9873OtherCAREFIRST
MD104698OtherUNITED CONCORDIA