Provider Demographics
NPI:1285888297
Name:PAULA J ROEMER, DDS INC
Entity type:Organization
Organization Name:PAULA J ROEMER, DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROEMER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-937-2100
Mailing Address - Street 1:1901 OLYMPIC BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5076
Mailing Address - Country:US
Mailing Address - Phone:925-937-2100
Mailing Address - Fax:925-937-1695
Practice Address - Street 1:1901 OLYMPIC BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5076
Practice Address - Country:US
Practice Address - Phone:925-937-2100
Practice Address - Fax:925-937-1695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33500261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA33500OtherSTATE LICENSE
233500OtherDELTA PROVIDER NUMBER