Provider Demographics
NPI:1215900733
Name:AYSON, PAUL F (DDS)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:F
Last Name:AYSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-6013
Mailing Address - Country:US
Mailing Address - Phone:559-791-7049
Mailing Address - Fax:559-734-1247
Practice Address - Street 1:101 N PALM ST
Practice Address - Street 2:
Practice Address - City:WOODLAKE
Practice Address - State:CA
Practice Address - Zip Code:93286-1422
Practice Address - Country:US
Practice Address - Phone:559-564-0100
Practice Address - Fax:559-564-2285
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46551122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist