Provider Demographics
NPI:1912158189
Name:MUSCARI, PAUL VINCENT (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:VINCENT
Last Name:MUSCARI
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:PO BOX 711
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37815-0711
Mailing Address - Country:US
Mailing Address - Phone:423-587-2660
Mailing Address - Fax:423-307-8796
Practice Address - Street 1:836 W 1ST NORTH ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-4548
Practice Address - Country:US
Practice Address - Phone:423-587-2660
Practice Address - Fax:423-307-8796
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS27971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
861042OtherUNITED CONCORDIA PROVIDER NUMBER
TN2008465OtherBLUE CROSS BLUE SHIELD PROVIDER NUMBER