Provider Demographics
NPI:1699745323
Name:TOMPACH, PAUL CHRISTOPHER (DDS, PHD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:CHRISTOPHER
Last Name:TOMPACH
Suffix:
Gender:M
Credentials:DDS, PHD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:515 DELAWARE STREET SE
Mailing Address - Street 2:7-174 MOOS HEALTH SCIENCES TOWER
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-301-2233
Mailing Address - Fax:612-625-2669
Practice Address - Street 1:515 DELAWARE STREET SE
Practice Address - Street 2:7-174 MOOS HEALTH SCIENCES TOWER
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-301-2233
Practice Address - Fax:612-625-2669
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MND11128204E00000X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery