Provider Demographics
NPI:1811493174
Name:PAUL G DAGINCOURT, M.D., PC
Entity type:Organization
Organization Name:PAUL G DAGINCOURT, M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:G
Authorized Official - Last Name:DAGINCOURT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-929-4914
Mailing Address - Street 1:27 HIGH ROCK ST
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-2701
Mailing Address - Country:US
Mailing Address - Phone:781-929-4914
Mailing Address - Fax:781-329-2422
Practice Address - Street 1:805 HIGH ST
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-2539
Practice Address - Country:US
Practice Address - Phone:781-929-4914
Practice Address - Fax:781-329-2422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-04
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA718662084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty