MEDICARE: DR. PAUL F CASELLE D.D.S.

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	13453	MA

General Provider Information

NPI Number	:	1952390403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL F CASELLE D.D.S.

Provider Business Mailing Address
First Line	:	211 LOWELL ST
Second Line	:	UNIT K
City	:	WILMINGTON
State	:	MA
Zip	:	01887-3014
Country	:	US
Telephone Number	:	978-657-4550
Fax Number	:	978-657-5828

Provider Business Practice Location Address
First Line	:	211 LOWELL ST
Second Line	:	UNIT K
City	:	WILMINGTON
State	:	MA
Zip	:	01887-3014
Country	:	US
Telephone Number	:	978-657-4550
Fax Number	:	978-657-5828

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	10/13/2015

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