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General NPI Number Information
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NPI Number | 1447929104
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Entity Type | Organization
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Legal Business Name | PAOLINO ORAL & FACIAL SURGERY CENTER PA
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Dates
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Enumeration Date | 09/07/2021
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Last Update Date | 09/07/2021
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Provider Practice Location Address
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Address Line | 1708 LOVERING AVE STE 101
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City | WILMINGTON
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State | DE
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Zip | 19806-2141
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Country | US
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Telephone | 302-319-4852
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Fax |
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Provider Business Mailing Address
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Address Line | 403 BRINTON LAKE RD
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City | THORNTON
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State | PA
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Zip | 19373-1090
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Country | US
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Telephone | 610-717-7004
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTOPHER ROBERT PAOLINO
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Credential | D.M.D.
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Telephone | 302-319-4852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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