Healthcare Provider Details

I. General information

NPI: 1194870162
Provider Name (Legal Business Name): PAUL P. BINON D.D.S., M.S.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1158 CIRBY WAY SUITE A
ROSEVILLE CA
95661-4422
US

IV. Provider business mailing address

1158 CIRBY WAY SUITE A
ROSEVILLE CA
95661-4422
US

V. Phone/Fax

Practice location:
  • Phone: 916-786-6676
  • Fax: 916-786-6820
Mailing address:
  • Phone: 916-786-6676
  • Fax: 916-786-6820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number20817
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: