Provider Demographics
NPI:1881843936
Name:PAULUS, BRENT COLLINS (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:COLLINS
Last Name:PAULUS
Suffix:
Gender:
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5665 MONCLOVA RD
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1835
Mailing Address - Country:US
Mailing Address - Phone:419-893-3376
Mailing Address - Fax:
Practice Address - Street 1:5665 MONCLOVA RD
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1835
Practice Address - Country:US
Practice Address - Phone:419-893-3376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-13
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101671223X0400X
OH30-02-27951223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics