Provider Demographics
NPI:1215166467
Name:DR PAUL APPELBAUM
Entity type:Organization
Organization Name:DR PAUL APPELBAUM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:APPELBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:401-433-2400
Mailing Address - Street 1:1445 WAMPANOAG TRL
Mailing Address - Street 2:209
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-1000
Mailing Address - Country:US
Mailing Address - Phone:401-433-2400
Mailing Address - Fax:401-433-2403
Practice Address - Street 1:1445 WAMPANOAG TRL
Practice Address - Street 2:209
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-1000
Practice Address - Country:US
Practice Address - Phone:401-433-2400
Practice Address - Fax:401-433-2403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI17181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty