Provider Demographics
NPI:1740536739
Name:PAULOWSKY WILDEY, MARY SARAH (DDS)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:SARAH
Last Name:PAULOWSKY WILDEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:PAULOWSKY
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:400 W HIGHWAY 290 STE B201
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-4382
Mailing Address - Country:US
Mailing Address - Phone:512-607-5300
Mailing Address - Fax:
Practice Address - Street 1:200 W HIGHWAY 290 STE B-201
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-3870
Practice Address - Country:US
Practice Address - Phone:512-607-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-27
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX280721223P0221X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist