Provider Demographics
NPI:1710244058
Name:PAWLOWICZ, JOHN (DMD, MICCMO, LVIF)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:PAWLOWICZ
Suffix:
Gender:M
Credentials:DMD, MICCMO, LVIF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 WINTER PARK DR
Mailing Address - Street 2:
Mailing Address - City:MARS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-3950
Mailing Address - Country:US
Mailing Address - Phone:724-779-1324
Mailing Address - Fax:
Practice Address - Street 1:732 WINTER PARK DR
Practice Address - Street 2:
Practice Address - City:MARS
Practice Address - State:PA
Practice Address - Zip Code:16046-3950
Practice Address - Country:US
Practice Address - Phone:412-629-2886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2024-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028809L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist