MEDICARE: DR. EDWARD DAVID PAUL D.D.S., M.S. F.A.G.D

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	7749	CT
2	1223P0700X	Prosthodontics	7749	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7749	OTHER	CT	LICENSE NUMBER

General Provider Information

NPI Number	:	1235132226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD DAVID PAUL D.D.S., M.S. F.A.G.D

Provider Business Mailing Address
First Line	:	161 EAST AVE STE 202
Second Line	:
City	:	NORWALK
State	:	CT
Zip	:	06851-5710
Country	:	US
Telephone Number	:	203-838-3938
Fax Number	:	203-866-5491

Provider Business Practice Location Address
First Line	:	161 EAST AVE STE 202
Second Line	:
City	:	NORWALK
State	:	CT
Zip	:	06851
Country	:	US
Telephone Number	:	203-838-3938
Fax Number	:

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	08/08/2018

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