Healthcare Provider Details

I. General information

NPI: 1730256140
Provider Name (Legal Business Name): PAUL ALEXANDER GERMAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5140 DORSEY HALL DR
ELLICOTT CITY MD
21042-7897
US

IV. Provider business mailing address

5140 DORSEY HALL DR
ELLICOTT CITY MD
21042-7897
US

V. Phone/Fax

Practice location:
  • Phone: 410-997-5826
  • Fax: 410-997-3200
Mailing address:
  • Phone: 410-997-5826
  • Fax: 410-997-3200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number11480
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: