Provider Demographics
NPI:1841511193
Name:PAULY, LINDSAY D (DDS)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:D
Last Name:PAULY
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:PO BOX 186
Mailing Address - Street 2:
Mailing Address - City:GARDEN PLAIN
Mailing Address - State:KS
Mailing Address - Zip Code:67050-0186
Mailing Address - Country:US
Mailing Address - Phone:316-209-1823
Mailing Address - Fax:
Practice Address - Street 1:431 VICTORIA RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-5653
Practice Address - Country:US
Practice Address - Phone:316-283-2970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS60679122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist