Provider Demographics
NPI:1902911217
Name:WINELAND, PAUL L (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:L
Last Name:WINELAND
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GOLDEN HILL ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-4630
Mailing Address - Country:US
Mailing Address - Phone:203-874-1664
Mailing Address - Fax:203-877-2027
Practice Address - Street 1:1 GOLDEN HILL ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-4630
Practice Address - Country:US
Practice Address - Phone:203-874-1664
Practice Address - Fax:203-877-2027
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT46831223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT020004683CT02OtherANTHEM BLUE CROSS & BLUE
CT190000455Medicare ID - Type Unspecified
CT020004683CT02OtherANTHEM BLUE CROSS & BLUE