Provider Demographics
NPI:1457602971
Name:DAVID F. PAVLICK DMD & ASSOCIATES LLC
Entity Type:Organization
Organization Name:DAVID F. PAVLICK DMD & ASSOCIATES LLC
Other - Org Name:THE PAVLICK COMPREHENSIVE DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:F
Authorized Official - Last Name:PAVLICK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:330-492-1500
Mailing Address - Street 1:4884 DRESSLER RD NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2544
Mailing Address - Country:US
Mailing Address - Phone:330-493-8197
Mailing Address - Fax:330-493-8198
Practice Address - Street 1:4884 DRESSLER RD NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2544
Practice Address - Country:US
Practice Address - Phone:330-493-8197
Practice Address - Fax:330-493-8198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH168791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty