Provider Demographics
NPI:1013047497
Name:STEIGERWALD, PAUL JAMES (DDS)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:JAMES
Last Name:STEIGERWALD
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 1:868 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-4610
Mailing Address - Country:US
Mailing Address - Phone:707-525-1228
Mailing Address - Fax:707-525-1137
Practice Address - Street 1:868 2ND ST
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4610
Practice Address - Country:US
Practice Address - Phone:707-525-1228
Practice Address - Fax:707-525-1137
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADK0366151223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADK036615OtherDENTAL LICENSE NUMBER