MEDICARE: PAUL F. AYSON D.D.S.

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	122300000X	Dentist	46551	CA

General Provider Information

NPI Number	:	1215900733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL F. AYSON D.D.S.

Provider Business Mailing Address
First Line	:	801 W CENTER AVE
Second Line	:
City	:	VISALIA
State	:	CA
Zip	:	93291-6013
Country	:	US
Telephone Number	:	559-791-7049
Fax Number	:	559-734-1247

Provider Business Practice Location Address
First Line	:	101 N PALM ST
Second Line	:
City	:	WOODLAKE
State	:	CA
Zip	:	93286-1422
Country	:	US
Telephone Number	:	559-564-0100
Fax Number	:	559-564-2285

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

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	07/08/2007

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