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NPI Code Detail

MEDICARE: DR. SEBASTIAN ZACHARY PAIGE D.D.S., M.S.D.

MEDICARE: DR. SEBASTIAN ZACHARY PAIGE D.D.S., M.S.D.
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
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry24955TX

General Provider Information

NPI Number : 1932495132
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SEBASTIAN ZACHARY PAIGE D.D.S., M.S.D.
Provider Business Mailing Address
First Line : 23830 US 59N
Second Line :
City : KINGWOOD
State : TX
Zip : 77339
Country : US
Telephone Number : 281-358-6580
Fax Number :
Provider Business Practice Location Address
First Line : 23830 HIGHWAY 59 N
Second Line :
City : KINGWOOD
State : TX
Zip : 77339-1510
Country : US
Telephone Number : 281-358-6580
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2011
Last Update Date : 04/10/2013

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