Healthcare Provider Details

I. General information

NPI: 1710998695
Provider Name (Legal Business Name): MONICA TERESA PAZ DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MONICA HARRINGTON DDS

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 05/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 HARRY KEMP WAY
PROVINCETOWN MA
02657-1618
US

IV. Provider business mailing address

3 TUPELO TER
EAST SANDWICH MA
02537-1420
US

V. Phone/Fax

Practice location:
  • Phone: 508-214-0187
  • Fax:
Mailing address:
  • Phone: 508-292-8273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License NumberDL12777
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: