MEDICARE: DR. PAUL ANTHONY DEMARCO III 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	11862	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730103169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL ANTHONY DEMARCO III DDS

Provider Business Mailing Address
First Line	:	130 PARKER ST
Second Line	:	#32
City	:	LAWRENCE
State	:	MA
Zip	:	01843
Country	:	US
Telephone Number	:	978-685-7011
Fax Number	:

Provider Business Practice Location Address
First Line	:	130 PARKER ST
Second Line	:
City	:	LAWRENCE
State	:	MA
Zip	:	01843
Country	:	US
Telephone Number	:	978-685-7011
Fax Number	:

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	02/15/2026

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