Provider Demographics
NPI:1588734602
Name:GASKINS, PAUL J (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:J
Last Name:GASKINS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7958 BRIAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27803-8525
Mailing Address - Country:US
Mailing Address - Phone:252-903-6250
Mailing Address - Fax:252-977-9031
Practice Address - Street 1:7958 BRIAR CREEK RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27803-8525
Practice Address - Country:US
Practice Address - Phone:252-903-6250
Practice Address - Fax:252-977-9031
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC79801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7980OtherLICENSE