Healthcare Provider Details

I. General information

NPI: 1073126322
Provider Name (Legal Business Name): PAUL DANIEL LEVEILLE DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2020
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 CENTER DR RM D1-17
GAINESVILLE FL
32610-3504
US

IV. Provider business mailing address

1537 UTICA ST
DENVER CO
80204-1237
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-5440
  • Fax: 352-273-5446
Mailing address:
  • Phone: 810-300-1608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDRPM2440
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN.00204465
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDEN00204465
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: