MEDICARE: DR. PAUL A. MAILSHANKER 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
1	1223G0001X	General Practice Dentistry	DS015920-L	PA

General Provider Information

NPI Number	:	1093853780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL A. MAILSHANKER DDS

Provider Business Mailing Address
First Line	:	1917 LIMEKILN PIKE
Second Line	:
City	:	DRESHER
State	:	PA
Zip	:	19025-1714
Country	:	US
Telephone Number	:	215-643-5336
Fax Number	:

Provider Business Practice Location Address
First Line	:	5660 DOUGHBOY LOOP
Second Line	:
City	:	FT.DIX
State	:	NJ
Zip	:	08640-5431
Country	:	US
Telephone Number	:	609-562-2610
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	07/08/2007

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