Provider Demographics
NPI:1366899163
Name:REDPATH, PAUL EDWARD (DMD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:EDWARD
Last Name:REDPATH
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:PO BOX 387
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:CO
Mailing Address - Zip Code:80435-0387
Mailing Address - Country:US
Mailing Address - Phone:732-801-9497
Mailing Address - Fax:
Practice Address - Street 1:330 DILLON RIDGE RD. SUITE 1
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:CO
Practice Address - Zip Code:80435
Practice Address - Country:US
Practice Address - Phone:970-262-2002
Practice Address - Fax:970-468-8866
Is Sole Proprietor?:No
Enumeration Date:2016-05-21
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CODEN.00203092122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program