Provider Demographics
NPI:1194739136
Name:BIEGLER, PAUL MARTIN (DMD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MARTIN
Last Name:BIEGLER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W LINCOLN ST
Mailing Address - Street 2:SUITE 54
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62220-1901
Mailing Address - Country:US
Mailing Address - Phone:618-277-3430
Mailing Address - Fax:
Practice Address - Street 1:301 W LINCOLN ST
Practice Address - Street 2:SUITE 54
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62220-1901
Practice Address - Country:US
Practice Address - Phone:618-277-3430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice