Provider Demographics
NPI:1972521334
Name:PAYNE, SAUL RICHARD (DMD)
Entity Type:Individual
Prefix:DR
First Name:SAUL
Middle Name:RICHARD
Last Name:PAYNE
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 1:855 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SO EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02375
Mailing Address - Country:US
Mailing Address - Phone:508-238-1515
Mailing Address - Fax:508-238-1565
Practice Address - Street 1:855 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SO EASTON
Practice Address - State:MA
Practice Address - Zip Code:02375
Practice Address - Country:US
Practice Address - Phone:508-238-1515
Practice Address - Fax:508-238-1565
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA124371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0244155Medicaid