Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 13487 | MA |
N | 204E00000X | Oral & Maxillofacial Surgeon | 10451 | NH |
NPI | 1558451914 |
---|---|
Provider Name | Dr. Paul C Kuo |
First Address | Newton, MA 02459-3065 |
Second Address | Brookline, MA 02446-5005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C90842 | (02) | IL |