Provider Demographics
NPI:1306928189
Name:GANGI, PAUL M (DMD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:M
Last Name:GANGI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:PM
Other - Middle Name:
Other - Last Name:GANGI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD INC
Mailing Address - Street 1:13 BRANCH STREET
Mailing Address - Street 2:MELTHUEN
Mailing Address - City:MELTHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844
Mailing Address - Country:US
Mailing Address - Phone:978-683-4114
Mailing Address - Fax:978-687-4491
Practice Address - Street 1:13 BRANCH STREET
Practice Address - Street 2:MELTHUEN
Practice Address - City:MELTHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844
Practice Address - Country:US
Practice Address - Phone:978-683-4114
Practice Address - Fax:978-687-4491
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA154741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice