Provider Demographics
NPI:1891052965
Name:PAWLOWICZ, JOHN S (DDS, FAGD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:PAWLOWICZ
Suffix:
Gender:M
Credentials:DDS, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 HANSEN AVE
Mailing Address - Street 2:
Mailing Address - City:LYNDORA
Mailing Address - State:PA
Mailing Address - Zip Code:16045
Mailing Address - Country:US
Mailing Address - Phone:724-287-4000
Mailing Address - Fax:724-287-4088
Practice Address - Street 1:516 HANSEN AVE
Practice Address - Street 2:
Practice Address - City:LYNDORA
Practice Address - State:PA
Practice Address - Zip Code:16045
Practice Address - Country:US
Practice Address - Phone:724-287-4000
Practice Address - Fax:724-287-4088
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS015794L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice