MEDICARE: DR. PAUL P. OUANO DMD

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	22DI01714300	NJ

General Provider Information

NPI Number	:	1881811727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL P. OUANO DMD

Provider Business Mailing Address
First Line	:	1872 STATE ROUTE 35
Second Line	:
City	:	SOUTH AMBOY
State	:	NJ
Zip	:	08879-2558
Country	:	US
Telephone Number	:	732-525-2242
Fax Number	:	732-525-2204

Provider Business Practice Location Address
First Line	:	1872 STATE ROUTE 35
Second Line	:
City	:	SOUTH AMBOY
State	:	NJ
Zip	:	08879-2558
Country	:	US
Telephone Number	:	732-525-2242
Fax Number	:	732-525-2204

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

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	07/08/2007

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