Provider Demographics
NPI:1376734186
Name:PASKALEV, IVAN P (DMD)
Entity Type:Individual
Prefix:DR
First Name:IVAN
Middle Name:P
Last Name:PASKALEV
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 WILLIAMETTE ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405
Mailing Address - Country:US
Mailing Address - Phone:541-726-9300
Mailing Address - Fax:541-726-9449
Practice Address - Street 1:2400 WILLIAMETTE ST.
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405
Practice Address - Country:US
Practice Address - Phone:541-726-9300
Practice Address - Fax:541-726-9449
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD89551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice