Healthcare Provider Details

I. General information

NPI: 1700921962
Provider Name (Legal Business Name): PAUL M KAPLAN DMD MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 JEFFERSON BLVD
WARWICK RI
02888
US

IV. Provider business mailing address

123 FOURTH STREET
PROVIDENCE RI
02906
US

V. Phone/Fax

Practice location:
  • Phone: 401-739-2350
  • Fax: 401-738-3569
Mailing address:
  • Phone: 401-954-3511
  • Fax: 401-954-3511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number2610
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number19251
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: