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General NPI Number Information
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NPI Number | 1013978956
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Entity Type | Individual
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Provider Name | PAUL GASTON DDS
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Gender | Male
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Dates
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Enumeration Date | 03/30/2006
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Last Update Date | 12/11/2012
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Provider Practice Location Address
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Address Line | 949 EAST LIVINGSTON AVENUE
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City | COLUMBUS
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State | OH
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Zip | 43205
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Country | US
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Telephone | 614-252-3181
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Fax | 614-252-1549
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Provider Business Mailing Address
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Address Line | 949 E LIVINGSTON AVE
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City | COLUMBUS
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State | OH
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Zip | 43205-2748
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Country | US
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Telephone | 614-252-3181
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Fax | 614-252-1549
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30018018
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License Number State | OH
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