Provider Demographics
NPI:1174223846
Name:ASPINWALL-REZENDE, PAULA ONOFRI
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:ONOFRI
Last Name:ASPINWALL-REZENDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 HILL ST
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3649
Mailing Address - Country:US
Mailing Address - Phone:781-635-0532
Mailing Address - Fax:
Practice Address - Street 1:55 HILL ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3649
Practice Address - Country:US
Practice Address - Phone:781-635-0532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-09
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1860000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist