Provider Demographics
NPI:1831340827
Name:ROMANELLI, PAUL NICHOLAS (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:NICHOLAS
Last Name:ROMANELLI
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 1:1504 N. RANDALL AVE.
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-1117
Mailing Address - Country:US
Mailing Address - Phone:608-752-0333
Mailing Address - Fax:608-752-2159
Practice Address - Street 1:1504 N. RANDALL AVE.
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-1117
Practice Address - Country:US
Practice Address - Phone:608-752-0333
Practice Address - Fax:608-752-2159
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIWI41001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics