MEDICARE: MICHELE PATERNO DMD, MSD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	22DIO1753000	NJ

General Provider Information

NPI Number	:	1053241000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE PATERNO DMD, MSD

Provider Business Mailing Address
First Line	:	4 JERRICK CT
Second Line	:
City	:	MOUNT LAUREL
State	:	NJ
Zip	:	08054-9525
Country	:	US
Telephone Number	:	609-680-1282
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 MOUNT LAUREL RD
Second Line	:
City	:	MOUNT LAUREL
State	:	NJ
Zip	:	08054-9554
Country	:	US
Telephone Number	:	856-722-5664
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2026
Last Update Date	:	05/21/2026

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Directions to “ MICHELE PATERNO DMD, MSD” Practice Location

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