Healthcare Provider Details

I. General information

NPI: 1316024060
Provider Name (Legal Business Name): PAUL EVAN ARNOLD JR. DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3161 OAKLAND AVE
CATLETTSBURG KY
41129-1155
US

IV. Provider business mailing address

3161 OAKLAND AVE PO BOX 356
CATLETTSBURG KY
41129-1155
US

V. Phone/Fax

Practice location:
  • Phone: 606-739-5151
  • Fax:
Mailing address:
  • Phone: 606-739-5151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number6791
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: