Provider Demographics
NPI:1124298583
Name:PAUL D. MIGHION,DDS AND ASSOCIATES, P.A.
Entity type:Organization
Organization Name:PAUL D. MIGHION,DDS AND ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:MIGHION
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:336-751-2364
Mailing Address - Street 1:198 HOSPITAL ST
Mailing Address - Street 2:
Mailing Address - City:MOCKSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27028-2008
Mailing Address - Country:US
Mailing Address - Phone:336-751-2364
Mailing Address - Fax:
Practice Address - Street 1:198 HOSPITAL ST
Practice Address - Street 2:
Practice Address - City:MOCKSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27028-2008
Practice Address - Country:US
Practice Address - Phone:336-751-2364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-01
Last Update Date:2008-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC53171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7995941Medicaid