Provider Demographics
NPI:1316956881
Name:PAUL L. WINBORN II, DDS, PA
Entity type:Organization
Organization Name:PAUL L. WINBORN II, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:L
Authorized Official - Last Name:WINBORN
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS
Authorized Official - Phone:479-478-9955
Mailing Address - Street 1:1501 S WALDRON RD STE 208
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-2565
Mailing Address - Country:US
Mailing Address - Phone:479-478-9955
Mailing Address - Fax:479-478-6632
Practice Address - Street 1:1501 S WALDRON RD STE 208
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-2565
Practice Address - Country:US
Practice Address - Phone:479-478-9955
Practice Address - Fax:479-478-6632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR32951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty