Basic Information
Provider Information
NPI: 1285157826
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OLIVEIRA
FirstName: PAULO
MiddleName: ARTUR
NamePrefix: DR.
NameSuffix:  
Credential: DDS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SALDANHA DE MENEZES OLIVEIRA
OtherFirstName: PAULO
OtherMiddleName: ARTUR
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: DDS
OtherLastNameType: 2
Mailing Information
Address1: 225 S CONGRESS AVE
Address2:  
City: DELRAY BEACH
State: FL
PostalCode: 334454616
CountryCode: US
TelephoneNumber: 5612792665
FaxNumber:  
Practice Location
Address1: 255 N CONGRESS AVE
Address2:  
City: DELRAY BEACH
State: FL
PostalCode: 334453418
CountryCode: US
TelephoneNumber: 5612792665
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/25/2017
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1223G0001XDN22922FLY Dental ProvidersDentistGeneral Practice

No ID Information.


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