Individual
DR. BART J. PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1957 PAWLISCH DR, ROCKFORD, IL 61112-1067
(815) 332-3477
Mailing address
1957 PAWLISCH DR, ROCKFORD, IL 61112-1067
(815) 332-3477
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.017887
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003279
—
IL
01
—
783656
UNITED CONCORDIA
IL
Enumeration date
01/30/2007
Last updated
07/09/2007
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