Provider Demographics
NPI:1255598090
Name:DIPAUL, EDWARD R (DMD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:R
Last Name:DIPAUL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 W BUTLER AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-5113
Mailing Address - Country:US
Mailing Address - Phone:215-345-6688
Mailing Address - Fax:215-345-5183
Practice Address - Street 1:433 W BUTLER AVE
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:PA
Practice Address - Zip Code:18901-5113
Practice Address - Country:US
Practice Address - Phone:215-345-6688
Practice Address - Fax:215-345-5183
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS017876L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice