Provider Demographics
NPI:1841226560
Name:MIGHION, PAUL DIAMOND (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DIAMOND
Last Name:MIGHION
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 1:198 HOSPITAL ST
Mailing Address - Street 2:
Mailing Address - City:MOCKSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27028-2008
Mailing Address - Country:US
Mailing Address - Phone:336-751-2364
Mailing Address - Fax:
Practice Address - Street 1:198 HOSPITAL ST
Practice Address - Street 2:
Practice Address - City:MOCKSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27028-2008
Practice Address - Country:US
Practice Address - Phone:336-751-2364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC53171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7995941Medicaid