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General NPI Number Information
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NPI Number | 1366648289
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Entity Type | Organization
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Legal Business Name | PAUL C. KAZMER, JR.,DMD,MS,PA
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 130 PRESTON EXECUTIVE DR SUITE 204
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City | CARY
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State | NC
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Zip | 27513-8433
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Country | US
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Telephone | 919-468-6410
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Fax | 919-468-4314
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Provider Business Mailing Address
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Address Line | 130 PRESTON EXECUTIVE DR SUITE 204
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City | CARY
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State | NC
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Zip | 27513-8433
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Country | US
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Telephone | 919-468-6410
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Fax | 919-468-4314
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL CHESTER KAZMER JR.
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Credential | DMD,MS.PA
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Telephone | 919-468-6410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 6578
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License Number State | NC
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