Provider Demographics
NPI:1114032703
Name:PAVLOFF, PAUL M (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:M
Last Name:PAVLOFF
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 1:6518 WINFORD DRIVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011
Mailing Address - Country:US
Mailing Address - Phone:513-867-0619
Mailing Address - Fax:513-867-9400
Practice Address - Street 1:6518 WINFORD DRIVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011
Practice Address - Country:US
Practice Address - Phone:513-867-0619
Practice Address - Fax:513-867-9400
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30016594122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist