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General NPI Number Information
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NPI Number | 1811191380
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Entity Type | Individual
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Provider Name | PAUL ANTHONY VIATOR DMD
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Gender | Male
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | HANMI BLDG MIDDLE RD NEW WAVE DENTAL CLINIC
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City | SAIPAN
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State | MP
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Zip | 96950
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Country | US
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Telephone | 670-233-3300
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Fax |
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Provider Business Mailing Address
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Address Line | PMB 271 BOX 10002
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City | SAIPAN
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State | MP
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Zip | 96950-8902
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Country | US
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Telephone | 670-788-2770
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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 | 0085
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License Number State | MP
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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 | 9246
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D7952
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License Number State | OR
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