Provider Demographics
NPI:1295718773
Name:FORTE, PAUL FREDERICK (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:FREDERICK
Last Name:FORTE
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 1:47 CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-7308
Mailing Address - Country:US
Mailing Address - Phone:978-744-8388
Mailing Address - Fax:978-744-0079
Practice Address - Street 1:89 FOSTER ST
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-8925
Practice Address - Country:US
Practice Address - Phone:978-744-8388
Practice Address - Fax:978-744-0079
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME34671223G0001X
MD81091223G0001X
MA143991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice