Individual
PAUL J FASANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
49 HARRY KEMP WAY, OUTER CAPE HEALTH SERVICES, INC., PROVINCETOWN, MA 02657
(508) 487-9395
(508) 487-3285
Mailing address
PO BOX 1413, WELLFLEET, MA 02667
(508) 240-0208
(508) 240-0499
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12020
MA
Other
Enumeration date
01/28/2014
Last updated
01/28/2014
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