Provider Demographics
NPI:1255050498
Name:DAVID A PAULISIN DDS PC
Entity type:Organization
Organization Name:DAVID A PAULISIN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:PAULISIN DDS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-516-5266
Mailing Address - Street 1:28807 8 MILE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-2080
Mailing Address - Country:US
Mailing Address - Phone:248-516-5266
Mailing Address - Fax:248-516-5267
Practice Address - Street 1:28807 8 MILE RD STE 101
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-2080
Practice Address - Country:US
Practice Address - Phone:248-516-5266
Practice Address - Fax:248-516-5267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental