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General NPI Number Information
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NPI Number | 1073700852
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Entity Type | Individual
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Provider Name | MARCUS L PAULUS DDS
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Gender | Male
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Dates
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Enumeration Date | 09/26/2007
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Last Update Date | 09/22/2021
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Provider Practice Location Address
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Address Line | 8292 E 12 MILE RD
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City | WARREN
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State | MI
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Zip | 48093-2737
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Country | US
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Telephone | 586-393-1516
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Fax | 586-393-1518
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Provider Business Mailing Address
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Address Line | PO BOX 3756
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City | SOUTHFIELD
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State | MI
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Zip | 48037-3756
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Country | US
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Telephone | 586-393-1516
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Fax | 586-393-1518
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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 | 5140
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901017341
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License Number State | MI
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