MEDICARE: CHRISTOPHER J. PAONI, D.D.S., P.A.

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	6708	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	17279	OTHER	KS	BL;UE CROSS BLUE SHIELD
2	875521	OTHER	KS	UNITED C ONCORDIA

General Provider Information

NPI Number	:	1568654010
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTOPHER J. PAONI, D.D.S., P.A.

Provider Business Mailing Address
First Line	:	106 S OZARK ST
Second Line	:
City	:	GIRARD
State	:	KS
Zip	:	66743-1530
Country	:	US
Telephone Number	:	620-724-6103
Fax Number	:	620-724-4328

Provider Business Practice Location Address
First Line	:	106 S OZARK ST
Second Line	:
City	:	GIRARD
State	:	KS
Zip	:	66743-1530
Country	:	US
Telephone Number	:	620-724-6103
Fax Number	:	620-724-4328

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CHRISTOPHER J PAONI
Credential	:	DDS
Telephone Number	:	620-724-6103

Provider Enumeration Date	:	08/17/2007
Last Update Date	:	08/17/2007

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