Provider Demographics
NPI:1487727368
Name:COFFEY, PAULA MEDLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:MEDLEY
Last Name:COFFEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3206
Mailing Address - Country:US
Mailing Address - Phone:919-286-1568
Mailing Address - Fax:
Practice Address - Street 1:3732 N ROXBORO ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2745
Practice Address - Country:US
Practice Address - Phone:919-471-6622
Practice Address - Fax:919-479-8679
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC47551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice