Provider Demographics
NPI:1013941459
Name:LINES, PAUL ANDERSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ANDERSON
Last Name:LINES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2415 S RURAL RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-2440
Mailing Address - Country:US
Mailing Address - Phone:480-968-3848
Mailing Address - Fax:480-967-8669
Practice Address - Street 1:2415 S RURAL RD
Practice Address - Street 2:SUITE B
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-2440
Practice Address - Country:US
Practice Address - Phone:480-968-3848
Practice Address - Fax:480-967-8669
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ15561223S0112X
MO117031223S0112X
NM9501223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics