Provider Demographics
NPI:1366528853
Name:BYERLY, PAUL D (DDS, MS)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:D
Last Name:BYERLY
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-3517
Mailing Address - Country:US
Mailing Address - Phone:336-227-0175
Mailing Address - Fax:336-229-0176
Practice Address - Street 1:1635 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-3517
Practice Address - Country:US
Practice Address - Phone:336-227-0175
Practice Address - Fax:336-229-0176
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC74141223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics