Provider Demographics
NPI:1912994617
Name:PAUL C SCHOENBECK, DMD., PA
Entity Type:Organization
Organization Name:PAUL C SCHOENBECK, DMD., PA
Other - Org Name:NORTH COUNTRY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHOENBECK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:603-466-5015
Mailing Address - Street 1:22 EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03581-1604
Mailing Address - Country:US
Mailing Address - Phone:603-466-5015
Mailing Address - Fax:603-466-5791
Practice Address - Street 1:22 EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:NH
Practice Address - Zip Code:03581-1604
Practice Address - Country:US
Practice Address - Phone:603-466-5015
Practice Address - Fax:603-466-5791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30008535Medicaid