Provider Demographics
NPI:1063850394
Name:PAVLOW, SARAH S (DMD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:S
Last Name:PAVLOW
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 REGINALD LN
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-1181
Mailing Address - Country:US
Mailing Address - Phone:267-992-6836
Mailing Address - Fax:
Practice Address - Street 1:555 SECOND AVE STE E-202
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-3622
Practice Address - Country:US
Practice Address - Phone:610-409-9880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-09
Last Update Date:2021-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0351941223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics