Provider Demographics
NPI:1871389619
Name:CHAVEZ AND PAULOVICH DENTAL CORPORATION
Entity type:Organization
Organization Name:CHAVEZ AND PAULOVICH DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PAULOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:440-488-6732
Mailing Address - Street 1:5200 SNYDER LN STE 3
Mailing Address - Street 2:
Mailing Address - City:ROHNERT PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94928-2931
Mailing Address - Country:US
Mailing Address - Phone:707-584-9589
Mailing Address - Fax:
Practice Address - Street 1:5200 SNYDER LN STE 3
Practice Address - Street 2:
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-2931
Practice Address - Country:US
Practice Address - Phone:707-584-9589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental