Provider Demographics
NPI:1750016036
Name:PAULEY, CHRISTINA ELISE (DDS)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ELISE
Last Name:PAULEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3574 WOODSTONE DR SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-1354
Mailing Address - Country:US
Mailing Address - Phone:507-226-1246
Mailing Address - Fax:
Practice Address - Street 1:973 SKYLINE DR SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-1220
Practice Address - Country:US
Practice Address - Phone:507-424-1040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND148131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice