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NPI Code Detail

MEDICARE: DR. PAUL VESOULIS DDS

MEDICARE:  DR. PAUL  VESOULIS  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry30-01-8297OH

General Provider Information

NPI Number : 1073516050
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL VESOULIS DDS
Provider Business Mailing Address
First Line : 4611 N SUMMIT ST
Second Line :
City : TOLEDO
State : OH
Zip : 43611-2812
Country : US
Telephone Number : 419-729-3972
Fax Number : 419-729-3938
Provider Business Practice Location Address
First Line : 4611 N SUMMIT ST
Second Line :
City : TOLEDO
State : OH
Zip : 43611-2812
Country : US
Telephone Number : 419-729-3972
Fax Number : 419-729-3938
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 07/08/2007

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Directions to “ DR. PAUL VESOULIS DDS” Practice Location

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