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General NPI Number Information
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NPI Number | 1770936171
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Entity Type | Individual
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Provider Name | DALLAS JOSEPH PAUL D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/20/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 14815 W BELL RD STE 202
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City | SURPRISE
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State | AZ
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Zip | 85374-7611
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Country | US
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Telephone | 632-547-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 4200 N FALCON DR UNIT 97
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City | GOODYEAR
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State | AZ
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Zip | 85395-2306
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Country | US
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Telephone | 702-305-5836
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DEN.00202857
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D009672
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License Number State | AZ
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