Provider Demographics
NPI:1538572961
Name:PAUL E MENTON DDS INC
Entity type:Organization
Organization Name:PAUL E MENTON DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:MENTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-265-3159
Mailing Address - Street 1:847 W MITCHELL ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-2506
Mailing Address - Country:US
Mailing Address - Phone:817-265-3159
Mailing Address - Fax:
Practice Address - Street 1:847 W MITCHELL ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-2506
Practice Address - Country:US
Practice Address - Phone:817-265-3159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-03
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX258031223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty