Provider Demographics
NPI:1841516655
Name:DR. PAUL FEVERSTEIN
Entity type:Organization
Organization Name:DR. PAUL FEVERSTEIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:H
Authorized Official - Last Name:FEVERSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-667-6600
Mailing Address - Street 1:76 TREBLE COVE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01862
Mailing Address - Country:US
Mailing Address - Phone:978-667-6600
Mailing Address - Fax:978-667-8519
Practice Address - Street 1:76 TREBLE COVE RD.
Practice Address - Street 2:
Practice Address - City:NORTH BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01862
Practice Address - Country:US
Practice Address - Phone:978-667-6600
Practice Address - Fax:978-667-8519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-19
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty