Provider Demographics
NPI:1366580870
Name:KAISER, PAUL CHRISTIAN (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:CHRISTIAN
Last Name:KAISER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:PAUL
Other - Middle Name:C
Other - Last Name:KAISER LTD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6220 PETERS CREEK RD NW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24019-4040
Mailing Address - Country:US
Mailing Address - Phone:540-362-1097
Mailing Address - Fax:540-362-8011
Practice Address - Street 1:6220 PETERS CREEK RD NW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24019-4040
Practice Address - Country:US
Practice Address - Phone:540-362-1097
Practice Address - Fax:540-362-8011
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVA80931223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics