Provider Demographics
NPI:1932268885
Name:ROEMER, PAULA (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:
Last Name:ROEMER
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 1:1901 OLYMPIC BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5076
Mailing Address - Country:US
Mailing Address - Phone:925-937-2100
Mailing Address - Fax:925-943-2673
Practice Address - Street 1:1901 OLYMPIC BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5076
Practice Address - Country:US
Practice Address - Phone:925-937-2100
Practice Address - Fax:925-943-2673
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA033500122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA233500OtherPROVIDER ID FOR DELTA
CA33500OtherPROVIDER ID FOR DELTA